Individual provider Active NPI

Daniel Jin Lee, DMD

  • Dentist
  • Acworth, GA
National Provider Identifier
1043397805
Registry record updated Aug 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DN013434 Issued in GA
Practice address
4569 Dallas Street
Acworth, GA 30101
Phone
(770) 974-4146
Fax
(770) 974-4146
NPI assigned
Nov 1, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 11, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DN013434 GA Primary

Addresses

Primary practice location

4569 Dallas Street
Acworth, GA 30101

Mailing address

8100 Saint Marlo Country Club Pkwy
Duluth, GA 30097-1625
Phone (770) 454-8432

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
DN013434GAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Daniel Lee DMD, PC Dentist CurrentSince Aug 13, 2023 Accepting new patients
Morrison Dental Associates, P.C. Dentist Past Accepting new patients

Locations

4569 Dallas St
Acworth, GA 30101
Phone (770) 974-4146

Organizations & group practices 2

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": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691712000000",
    "number": "1043397805",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8100 SAINT MARLO COUNTRY CLUB PKWY",
            "city": "DULUTH",
            "state": "GA",
            "postal_code": "300971625",
            "telephone_number": "770-454-8432",
            "fax_number": "678-990-9799"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4569 DALLAS STREET",
            "city": "ACWORTH",
            "state": "GA",
            "postal_code": "30101",
            "telephone_number": "770-974-4146",
            "fax_number": "770-974-4146"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "DANIEL",
        "middle_name": "JIN",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-01",
        "last_updated": "2023-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "GA",
            "license": "DN013434",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Acworth, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.