Individual provider Active NPI

Jacob J Lee, DDS

  • General Practice Dentistry
  • Dalton, GA
National Provider Identifier
1174543847
Registry record updated May 27, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
013134 Issued in GA
Practice address
1006 Professional Blvd
Suite B
Dalton, GA 30720-2505
Phone
(706) 226-2228
Fax
(706) 226-1881
NPI assigned
Jul 19, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 27, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 013134 GA Primary

Addresses

Primary practice location

1006 Professional Blvd
Suite B
Dalton, GA 30720-2505

Mailing address

1006 Professional Blvd
Suite B
Dalton, GA 30720
Phone (706) 226-2228

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20170209000260 GA Order and Referring Only - DentistPractitioner - Dentist 3173806569

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
013134GAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Lee-Voegele LLC PastSince Nov 6, 2022 Accepting new patients

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": "1153267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1243382400000",
    "number": "1174543847",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1006 PROFESSIONAL BLVD",
            "address_2": "SUITE B",
            "city": "DALTON",
            "state": "GA",
            "postal_code": "30720",
            "telephone_number": "706-226-2228",
            "fax_number": "706-226-1881"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1006 PROFESSIONAL BLVD",
            "address_2": "SUITE B",
            "city": "DALTON",
            "state": "GA",
            "postal_code": "307202505",
            "telephone_number": "706-226-2228",
            "fax_number": "706-226-1881"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "JACOB",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-19",
        "last_updated": "2009-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "GA",
            "license": "013134",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dalton, GA

Sources for this page

Verify at the official NPI Registry.