Provider Demographics
NPI:1174723704
Name:LUN SU YEE DDS, INC.
Entity type:Organization
Organization Name:LUN SU YEE DDS, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LUN
Authorized Official - Middle Name:SU
Authorized Official - Last Name:YEE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:650-992-7799
Mailing Address - Street 1:36 SAN PEDRO RD
Mailing Address - Street 2:
Mailing Address - City:DALY CITY
Mailing Address - State:CA
Mailing Address - Zip Code:94014-2528
Mailing Address - Country:US
Mailing Address - Phone:650-992-7799
Mailing Address - Fax:650-992-7795
Practice Address - Street 1:36 SAN PEDRO RD
Practice Address - Street 2:
Practice Address - City:DALY CITY
Practice Address - State:CA
Practice Address - Zip Code:94014-2528
Practice Address - Country:US
Practice Address - Phone:650-992-7799
Practice Address - Fax:650-992-7795
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-23
Last Update Date:2007-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC2275492305S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305S00000XManaged Care OrganizationsPoint of Service
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAB3972601OtherDENTI-CAL