Provider Demographics
NPI:1790660355
Name:LEE HUNG, IRENE BEATRIZ (DDS)
Entity type:Individual
Prefix:
First Name:IRENE
Middle Name:BEATRIZ
Last Name:LEE HUNG
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:278 MONROE DR APT 18
Mailing Address - Street 2:
Mailing Address - City:MOUNTAIN VIEW
Mailing Address - State:CA
Mailing Address - Zip Code:94040-1001
Mailing Address - Country:US
Mailing Address - Phone:415-994-3858
Mailing Address - Fax:
Practice Address - Street 1:2998 EL CAMINO REAL STE 200
Practice Address - Street 2:
Practice Address - City:SANTA CLARA
Practice Address - State:CA
Practice Address - Zip Code:95051-2938
Practice Address - Country:US
Practice Address - Phone:408-241-2397
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-11
Last Update Date:2025-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1118021223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice