Jeffery S. Lee, DDS MS

Primary specialty

DentistTaxonomy code 122300000X

License

30021802 Issued in OH

Practice address

510 Arends Ridge Road
Marietta, OH 45750

Phone

(740) 236-9392

Fax

(740) 439-0894

NPI assigned

Jan 19, 2006

Last updated

Sep 17, 2024By the provider in NPPES

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Apr 1, 2017 through Apr 1, 2027

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Muskingum Valley Oral Surgery, Inc.

  • Oral and Maxillofacial Surgery Clinic/Center
  • Marietta, OH
  • NPI 1013450014
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1137628800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726531200000",
    "number": "1013997519",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "510 ARENDS RIDGE ROAD",
            "city": "MARIETTA",
            "state": "OH",
            "postal_code": "45750",
            "telephone_number": "740-236-9392",
            "fax_number": "740-439-0894"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "510 ARENDS RIDGE ROAD",
            "city": "MARIETTA",
            "state": "OH",
            "postal_code": "45750",
            "telephone_number": "740-236-9392",
            "fax_number": "740-439-0894"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "JEFFERY",
        "middle_name": "S.",
        "name_prefix": "Mr.",
        "credential": "DDS MS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-01-19",
        "last_updated": "2024-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "OH",
            "license": "30021802",
            "primary": true
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "OH",
            "license": "30.021802",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0230158",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ryan Wesley Layton, D.D.S.
• Michael Gregory Lazear, RN
• Cathy J. Lee, N.P.
• Heidi M Lee, LPN
• Janet Lee, REGISTERED NURSE
• John Chong Lee, MD
• Lane M Lee, DO
• Sonja Lee, LPN
• Teri Lee
• Legacy Marietta Operating Company, LLC (Legacy Marietta)

• Dentist in Marietta, OH
• Providers in Marietta, OH by specialty
• Dentist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.