Provider Demographics
NPI:1407380025
Name:JU YOUNG LEE DDS INC
Entity type:Organization
Organization Name:JU YOUNG LEE DDS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:JU
Authorized Official - Middle Name:YOUNG
Authorized Official - Last Name:LEE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:714-817-8345
Mailing Address - Street 1:2500 W 8TH ST
Mailing Address - Street 2:106
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90057-3860
Mailing Address - Country:US
Mailing Address - Phone:213-381-2827
Mailing Address - Fax:213-381-2829
Practice Address - Street 1:2500 W 8TH ST
Practice Address - Street 2:106
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90057-3860
Practice Address - Country:US
Practice Address - Phone:213-381-2827
Practice Address - Fax:213-381-2829
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-04-20
Last Update Date:2017-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA612581223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty