Active NPI
Jennifer Lee
- Dentist
- Suffern, NY
National Provider Identifier
1215557863
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 062840-01
- Practice address
- 7 Hemion Rd
Suffern, NY 10901-4919 - Phone
- (845) 202-1367
- NPI assigned
- Apr 23, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | DI2848800 | NJ | |
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Dentist | 122300000X | 062840-01 | NY | Primary |
Addresses
Primary practice location
7 Hemion Rd
Suffern, NY 10901-4919
Mailing address
240 Walker St Unit 3E
Cliffside Park, NJ 07010-1184
Phone (845) 270-9199
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 |
|---|---|---|---|
| 062840-01 | NY | MD | Dentist |
| DI2848800 | NJ | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1587600000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1667606400000",
"number": "1215557863",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "240 WALKER ST UNIT 3E",
"city": "CLIFFSIDE PARK",
"state": "NJ",
"postal_code": "070101184",
"telephone_number": "845-270-9199"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7 HEMION RD",
"city": "SUFFERN",
"state": "NY",
"postal_code": "109014919",
"telephone_number": "845-202-1367"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEE",
"first_name": "JENNIFER",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-04-23",
"last_updated": "2022-11-05",
"certification_date": "2022-11-05",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "NJ",
"license": "DI2848800",
"primary": false
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "NY",
"license": "062840-01",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Suffern, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.