Provider Demographics
NPI:1053361907
Name:LEE, BRIAN YUN (DDS)
Entity type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:YUN
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 1:1629 W AVENUE J
Mailing Address - Street 2:SUITE 103
Mailing Address - City:LANCASTER
Mailing Address - State:CA
Mailing Address - Zip Code:93534-2830
Mailing Address - Country:US
Mailing Address - Phone:661-948-7722
Mailing Address - Fax:661-948-7744
Practice Address - Street 1:1629 W AVENUE J
Practice Address - Street 2:SUITE 103
Practice Address - City:LANCASTER
Practice Address - State:CA
Practice Address - Zip Code:93534-2830
Practice Address - Country:US
Practice Address - Phone:661-948-7722
Practice Address - Fax:661-948-7744
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-11
Last Update Date:2013-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA431841223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice