Individual
DR. JAE YONG LEE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD PHD
Contact information
Practice address
5014B PRESTON HWY, LOUISVILLE, KY 40213-2217
(502) 966-0188
Mailing address
5014B PRESTON HWY, LOUISVILLE, KY 40213-2217
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
0401417153
VA
122300000X
Dentist
Primary
10520
KY
122300000X
Dentist
105652
CA
122300000X
Dentist
11405
TN
122300000X
Dentist
12013758A
IN
122300000X
Dentist
30.027201
OH
Other
Enumeration date
04/03/2020
Last updated
04/01/2026
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