Active NPI
Jeewon Jenny Lee
- Audiologist
- Surprise, AZ
National Provider Identifier
1104613488
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Audiologist
- License
- A4741
- Practice address
- 13985 W Grand Ave Ste 101
Surprise, AZ 85374-3626 - Phone
- (623) 251-2884
- NPI assigned
- Apr 22, 2025
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Audiologist | 231H00000X | A4741 | MS | Primary |
Addresses
Primary practice location
13985 W Grand Ave Ste 101
Surprise, AZ 85374-3626
Mailing address
6121 W Zoe Ella Way
Glendale, AZ 85306-2930
Phone (909) 670-5914
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
| License | State | Type | Specialty |
|---|---|---|---|
| A4741 | MS | MD | Audiologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1745280000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1745280000000",
"number": "1104613488",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6121 W ZOE ELLA WAY",
"city": "GLENDALE",
"state": "AZ",
"postal_code": "853062930",
"telephone_number": "909-670-5914"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "13985 W GRAND AVE STE 101",
"city": "SURPRISE",
"state": "AZ",
"postal_code": "853743626",
"telephone_number": "623-251-2884"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEE",
"first_name": "JEEWON",
"middle_name": "JENNY",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2025-04-22",
"last_updated": "2025-04-22",
"certification_date": "2025-04-22",
"status": "A"
},
"taxonomies": [
{
"code": "231H00000X",
"taxonomy_group": "",
"desc": "Audiologist",
"state": "MS",
"license": "A4741",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Surprise, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.