Provider Demographics
NPI:1386731206
Name:LEE, RANA (DDS01)
Entity type:Individual
Prefix:DR
First Name:RANA
Middle Name:
Last Name:LEE
Suffix:
Gender:F
Credentials:DDS01
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2204 W SHADY GROVE RD
Mailing Address - Street 2:
Mailing Address - City:IRVING
Mailing Address - State:TX
Mailing Address - Zip Code:75060-5056
Mailing Address - Country:US
Mailing Address - Phone:972-790-5055
Mailing Address - Fax:972-986-7760
Practice Address - Street 1:2204 W SHADY GROVE RD
Practice Address - Street 2:
Practice Address - City:IRVING
Practice Address - State:TX
Practice Address - Zip Code:75060-5056
Practice Address - Country:US
Practice Address - Phone:972-790-5055
Practice Address - Fax:972-986-7760
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX181801223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice