Provider Demographics
NPI:1558249227
Name:LEE PEDIATRIC DENTITSRY PLLC
Entity type:Organization
Organization Name:LEE PEDIATRIC DENTITSRY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PEDIATRIC DENTIST / PRACTICE OWNER
Authorized Official - Prefix:
Authorized Official - First Name:HYUNJEONG
Authorized Official - Middle Name:
Authorized Official - Last Name:LEE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:917-617-8551
Mailing Address - Street 1:15 SHADY LN
Mailing Address - Street 2:
Mailing Address - City:WOODBRIDGE
Mailing Address - State:CT
Mailing Address - Zip Code:06525-2030
Mailing Address - Country:US
Mailing Address - Phone:917-617-8551
Mailing Address - Fax:
Practice Address - Street 1:24 COLONY ST UNIT B
Practice Address - Street 2:
Practice Address - City:MERIDEN
Practice Address - State:CT
Practice Address - Zip Code:06451-3215
Practice Address - Country:US
Practice Address - Phone:917-617-8551
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-08-21
Last Update Date:2025-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Multi-Specialty