MEDICARE: SUNG Y. LEE DMD INC

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
1	261QD0000X	Dental Clinic/Center

General Provider Information

NPI Number	:	1871458414
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SUNG Y. LEE DMD INC

Provider Business Mailing Address
First Line	:	1757 W CARSON ST STE E
Second Line	:
City	:	TORRANCE
State	:	CA
Zip	:	90501-2828
Country	:	US
Telephone Number	:	714-722-1222
Fax Number	:

Provider Business Practice Location Address
First Line	:	1757 W CARSON ST STE E
Second Line	:
City	:	TORRANCE
State	:	CA
Zip	:	90501-2828
Country	:	US
Telephone Number	:	714-722-1222
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	SUNG Y LEE
Credential	:	DMD
Telephone Number	:	714-722-1222

Provider Enumeration Date	:	12/17/2025
Last Update Date	:	12/17/2025

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