Provider Demographics
NPI:1548284334
Name:LEE, JESSICA YUNA (DDS, MPH, PHD)
Entity type:Individual
Prefix:DR
First Name:JESSICA
Middle Name:YUNA
Last Name:LEE
Suffix:
Gender:F
Credentials:DDS, MPH, PHD
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Mailing Address - Street 1:150 DENTAL CIR
Mailing Address - Street 2:DENTAL FACULTY PRACTICE
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27599-7450
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:150 DENTAL CIR
Practice Address - Street 2:DENTAL FACULTY PRACTICE
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27599-7450
Practice Address - Country:US
Practice Address - Phone:919-537-3940
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-26
Last Update Date:2014-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY049178-11223P0221X
NC00171223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1548284334Medicaid