Provider Demographics
NPI:1962930974
Name:LEE, MENG HUAN (DMD)
Entity type:Individual
Prefix:DR
First Name:MENG HUAN
Middle Name:
Last Name:LEE
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2518 LIESFELD PKWY
Mailing Address - Street 2:
Mailing Address - City:GLEN ALLEN
Mailing Address - State:VA
Mailing Address - Zip Code:23060-5859
Mailing Address - Country:US
Mailing Address - Phone:216-926-5860
Mailing Address - Fax:
Practice Address - Street 1:151 SULLYS TRL STE 1
Practice Address - Street 2:
Practice Address - City:PITTSFORD
Practice Address - State:NY
Practice Address - Zip Code:14534-4562
Practice Address - Country:US
Practice Address - Phone:585-385-4867
Practice Address - Fax:585-872-4395
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-03
Last Update Date:2024-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0610291223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0300XDental ProvidersDentistPeriodonticsGroup - Single Specialty