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NPI Code Detail

MEDICARE: DR. SUSAN THUYMINH LEE D. D. S.

MEDICARE:  DR. SUSAN THUYMINH LEE  D. D. S.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1122300000XDentist47750CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1G93237-01OTHERCADENTI-CAL

General Provider Information

NPI Number : 1841417391
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. SUSAN THUYMINH LEE D. D. S.
Provider Business Mailing Address
First Line : 2726 ABORN RD
Second Line : STE. K
City : SAN JOSE
State : CA
Zip : 95121-1276
Country : US
Telephone Number : 408-270-7723
Fax Number : 408-223-8717
Provider Business Practice Location Address
First Line : 2726 ABORN RD
Second Line : STE. K
City : SAN JOSE
State : CA
Zip : 95121-1276
Country : US
Telephone Number : 408-270-7723
Fax Number : 408-223-8717
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/19/2007
Last Update Date : 02/11/2016

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