Provider Demographics
NPI:1063610145
Name:LEE, JOCELYN Y (DDS)
Entity type:Individual
Prefix:DR
First Name:JOCELYN
Middle Name:Y
Last Name:LEE
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:39639 LESLIE ST APT 279
Mailing Address - Street 2:
Mailing Address - City:FREMONT
Mailing Address - State:CA
Mailing Address - Zip Code:94538-2260
Mailing Address - Country:US
Mailing Address - Phone:510-295-8422
Mailing Address - Fax:
Practice Address - Street 1:39639 LESLIE ST APT 279
Practice Address - Street 2:
Practice Address - City:FREMONT
Practice Address - State:CA
Practice Address - Zip Code:94538-2260
Practice Address - Country:US
Practice Address - Phone:510-295-8422
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-07-10
Last Update Date:2007-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA54916122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist