Provider Demographics
NPI:1609216720
Name:LEE, EDWARD Y (DDS)
Entity type:Individual
Prefix:MR
First Name:EDWARD
Middle Name:Y
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 1:12880 COLORADO BLVD
Mailing Address - Street 2:SUITE 230
Mailing Address - City:THORNTON
Mailing Address - State:CO
Mailing Address - Zip Code:80241
Mailing Address - Country:US
Mailing Address - Phone:303-457-1513
Mailing Address - Fax:303-280-2922
Practice Address - Street 1:12880 COLORADO BLVD
Practice Address - Street 2:SUITE 230
Practice Address - City:THORNTON
Practice Address - State:CO
Practice Address - Zip Code:80241
Practice Address - Country:US
Practice Address - Phone:303-457-1513
Practice Address - Fax:303-280-2922
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-03
Last Update Date:2023-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO2020051223G0001X
NV64781223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice