Individual provider Active NPI

Jessica Lee, DDS

  • Dentist
  • Brookhaven, GA
National Provider Identifier
1043528193
Registry record updated Oct 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DN014152 Issued in GA
Practice address
3438 Clairmont Rd NE
Brookhaven, GA 30319-3720
Phone
(614) 832-8524
NPI assigned
Sep 22, 2010
Last updated
Oct 10, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 10, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DN014152 GA Primary

Addresses

Primary practice location

3438 Clairmont Rd NE
Brookhaven, GA 30319-3720

Mailing address

3438 Clairmont Rd NE
Brookhaven, GA 30319-3720
Phone (614) 832-8524

Other practice location 1

5040 Snapfinger Woods Dr Ste 203
Decatur, GA 30035-4020
Phone (770) 981-9700

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
DN014152GAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Atlanta Dental Studio CurrentSince Oct 13, 2024 Accepting new patients
Smith and Correll DDS PC Past Accepting new patients
East Atlanta Dental PastSince Jun 26, 2022 Accepting new patients

Locations

3438 Clairmont Rd NE
Brookhaven, GA 30319
Phone (614) 832-8524

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1285113600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728518400000",
    "number": "1043528193",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3438 CLAIRMONT RD NE",
            "city": "BROOKHAVEN",
            "state": "GA",
            "postal_code": "303193720",
            "telephone_number": "614-832-8524"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3438 CLAIRMONT RD NE",
            "city": "BROOKHAVEN",
            "state": "GA",
            "postal_code": "303193720",
            "telephone_number": "614-832-8524"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5040 Snapfinger Woods Dr Ste 203",
            "address_purpose": "LOCATION",
            "city": "Decatur",
            "state": "GA",
            "postal_code": "300354020",
            "country_code": "US",
            "telephone_number": "770-981-9700",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEE",
        "first_name": "JESSICA",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-09-22",
        "last_updated": "2024-10-10",
        "certification_date": "2024-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "GA",
            "license": "DN014152",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brookhaven, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2024; 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.