Provider Demographics
NPI:1720174527
Name:LEE, CHRISTIAN WOOJUNG (DDS)
Entity type:Individual
Prefix:DR
First Name:CHRISTIAN
Middle Name:WOOJUNG
Last Name:LEE
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:730 SUNRISE AVE STE 110
Mailing Address - Street 2:
Mailing Address - City:ROSEVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95661-4549
Mailing Address - Country:US
Mailing Address - Phone:916-784-6510
Mailing Address - Fax:916-784-9017
Practice Address - Street 1:730 SUNRISE AVE STE 110
Practice Address - Street 2:
Practice Address - City:ROSEVILLE
Practice Address - State:CA
Practice Address - Zip Code:95661-4549
Practice Address - Country:US
Practice Address - Phone:916-784-6510
Practice Address - Fax:916-784-9017
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-05
Last Update Date:2023-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA50484122300000X, 1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No122300000XDental ProvidersDentist