Individual provider Active NPI

Katherine J Southwell Lee, D.D.S.

  • Dentist
  • Charlottesville, VA
National Provider Identifier
1033347174
Registry record updated Apr 10, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
0401412487 Issued in VA
Practice address
240 Hydraulic Ridge Rd
Ste. 103
Charlottesville, VA 22901-8130
Phone
(434) 953-9794
NPI assigned
Jun 28, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 10, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 0401412487 VA Primary

Addresses

Primary practice location

240 Hydraulic Ridge Rd
Ste. 103
Charlottesville, VA 22901-8130

Mailing address

5231 Park Ridge CT
Crozet, VA 22932-3162
Phone (434) 953-9794

Other practice location 1

1222 Jefferson Park Ave
Charlottesville, VA 22903-3410
Phone (434) 924-1774

Other practice location 2

1215 Lee St
Charlottesville, VA 22908-8130
Phone (434) 924-0211

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120803000243 VA Practitioner - DentistPractitioner - Oral Surgery 1759537970 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0401412487VAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
University of Virginia Physicians Group CurrentSince Apr 27, 2022 Accepting new patients

Locations

1222 Jefferson Park Ave
Fl 2
Charlottesville, VA 22903
Phone (434) 924-1774

1222 Jefferson Park Ave
Charlottesville, VA 22903
Phone (434) 924-1774

1215 Lee St
Charlottesvle, VA 22908
Phone (434) 924-0211

1215 Lee St
Fl 8
Charlottesvle, VA 22908
Phone (434) 924-2500

Interoperability endpoints

  • Direct secure messaging: klee501658@direct.healthsystem.virginia.edu

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1246147200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1775779200000",
    "number": "1033347174",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5231 PARK RIDGE CT",
            "city": "CROZET",
            "state": "VA",
            "postal_code": "229323162",
            "telephone_number": "434-953-9794"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "240 HYDRAULIC RIDGE RD",
            "address_2": "STE. 103",
            "city": "CHARLOTTESVILLE",
            "state": "VA",
            "postal_code": "229018130",
            "telephone_number": "434-953-9794"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1222 Jefferson Park Ave",
            "address_purpose": "LOCATION",
            "city": "Charlottesville",
            "state": "VA",
            "postal_code": "229033410",
            "country_code": "US",
            "telephone_number": "434-924-1774",
            "fax_number": "434-243-6378",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1215 Lee St",
            "address_purpose": "LOCATION",
            "city": "Charlottesville",
            "state": "VA",
            "postal_code": "229088130",
            "country_code": "US",
            "telephone_number": "434-924-0211",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEE",
        "first_name": "KATHERINE",
        "middle_name": "J SOUTHWELL",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-06-28",
        "last_updated": "2026-04-10",
        "certification_date": "2026-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "VA",
            "license": "0401412487",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlottesville, VA

Sources for this page

Verify at the official NPI Registry.