Provider Demographics
NPI:1194920850
Name:LEE, MARGARET (DDS)
Entity type:Individual
Prefix:
First Name:MARGARET
Middle Name:
Last Name:LEE
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:MARGARET
Other - Middle Name:
Other - Last Name:WONG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS
Mailing Address - Street 1:1058 KEOLU DR
Mailing Address - Street 2:
Mailing Address - City:KAILUA
Mailing Address - State:HI
Mailing Address - Zip Code:96734-3845
Mailing Address - Country:US
Mailing Address - Phone:808-848-2400
Mailing Address - Fax:808-847-2238
Practice Address - Street 1:1058 KEOLU DR
Practice Address - Street 2:
Practice Address - City:KAILUA
Practice Address - State:HI
Practice Address - Zip Code:96734-3845
Practice Address - Country:US
Practice Address - Phone:808-848-2400
Practice Address - Fax:808-847-2238
Is Sole Proprietor?:No
Enumeration Date:2007-06-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIDT 16461223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI844717OtherUNITED CONCODIA LOC 2
HI164602OtherHDSLOC 2
HIB0078192OtherHMSA LOC 2
HI05884902Medicaid