Provider Demographics
NPI:1861384588
Name:LEE, JONATHAN JOONHYUNG (DDS)
Entity type:Individual
Prefix:DR
First Name:JONATHAN
Middle Name:JOONHYUNG
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 1:27000 W LUGONIA AVE APT 12109
Mailing Address - Street 2:
Mailing Address - City:REDLANDS
Mailing Address - State:CA
Mailing Address - Zip Code:92374-2097
Mailing Address - Country:US
Mailing Address - Phone:909-583-5984
Mailing Address - Fax:
Practice Address - Street 1:29273 CENTRAL AVE STE A
Practice Address - Street 2:
Practice Address - City:LAKE ELSINORE
Practice Address - State:CA
Practice Address - Zip Code:92532-2254
Practice Address - Country:US
Practice Address - Phone:951-245-8664
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-17
Last Update Date:2025-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA111863122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist