Provider Demographics
NPI:1801041199
Name:LEE, IK SUNG DANNY (DMD)
Entity type:Individual
Prefix:DR
First Name:IK SUNG DANNY
Middle Name:
Last Name:LEE
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:DR
Other - First Name:DANNY
Other - Middle Name:IK SUNG
Other - Last Name:LEE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DMD
Mailing Address - Street 1:346 N AZUSA AVE
Mailing Address - Street 2:
Mailing Address - City:WEST COVINA
Mailing Address - State:CA
Mailing Address - Zip Code:91791-1345
Mailing Address - Country:US
Mailing Address - Phone:626-859-2439
Mailing Address - Fax:626-967-2351
Practice Address - Street 1:346 N AZUSA AVE
Practice Address - Street 2:
Practice Address - City:WEST COVINA
Practice Address - State:CA
Practice Address - Zip Code:91791-1345
Practice Address - Country:US
Practice Address - Phone:626-859-2439
Practice Address - Fax:626-967-2351
Is Sole Proprietor?:No
Enumeration Date:2008-12-01
Last Update Date:2008-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA471141223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice