Provider Demographics
NPI:1285977496
Name:LEE, I-SHYEAN (DDS)
Entity type:Individual
Prefix:
First Name:I-SHYEAN
Middle Name:
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 1:2020 WADSWORTH BLVD STE 9
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80214-5730
Mailing Address - Country:US
Mailing Address - Phone:303-431-1221
Mailing Address - Fax:
Practice Address - Street 1:2020 WADSWORTH BLVD STE 9
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80214-5730
Practice Address - Country:US
Practice Address - Phone:303-431-1221
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-04-05
Last Update Date:2013-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO002019251223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice