MEDICARE: DANIEL LEE, DDS, AND CHRISTINA LEE, DDS, MS, PLLC

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	1223X0400X	Orthodontics and Dentofacial Orthopedics Dentistry
2	122300000X	Dentist

General Provider Information

NPI Number	:	1891250429
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DANIEL LEE, DDS, AND CHRISTINA LEE, DDS, MS, PLLC

Provider Business Mailing Address
First Line	:	820 BLANCHARD ST UNIT 1406
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98121-2655
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2911 2ND AVE
Second Line	:	SUITE 106
City	:	SEATTLE
State	:	WA
Zip	:	98121-3065
Country	:	US
Telephone Number	:	917-868-7381
Fax Number	:

Authorized Official
Title or Position	:	ORTHODONTIST
Name	:	DR. CHRISTINA LEE
Credential	:	DDS, MS
Telephone Number	:	917-868-7381

Provider Enumeration Date	:	02/07/2019
Last Update Date	:	02/07/2019

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