Provider Demographics
NPI:1962220590
Name:JL SMILE DENTISTRY
Entity type:Organization
Organization Name:JL SMILE DENTISTRY
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:JAE WOO
Authorized Official - Last Name:LEE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:972-786-6920
Mailing Address - Street 1:1011 GREEN KENSINGTON DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77008-1090
Mailing Address - Country:US
Mailing Address - Phone:972-786-6920
Mailing Address - Fax:
Practice Address - Street 1:27104 TX HWY 249
Practice Address - Street 2:BLDG B STE B.800
Practice Address - City:TOMBALL
Practice Address - State:TX
Practice Address - Zip Code:77375
Practice Address - Country:US
Practice Address - Phone:281-826-5131
Practice Address - Fax:281-826-5283
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-02
Last Update Date:2025-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty
No261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental