Ja Eun Lee, D.D.S

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

0000011751 Issued in TN

Practice address

1777 Madison St
Clarksville, TN 37043-4909

Phone

(931) 202-9151

NPI assigned

Jun 28, 2011

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other names 1

• Dr. Jaja Lee Other name

Medicare fee-for-service enrollment

Enrolled in TN

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Morrison Dental Associates, P.C.

  • Dentist
  • Brunswick, GA
  • NPI 1427285600
  NPD (past)

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

{
    "created_epoch": "1309219200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710374400000",
    "number": "1386930394",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1777 MADISON ST",
            "city": "CLARKSVILLE",
            "state": "TN",
            "postal_code": "370434909",
            "telephone_number": "931-202-9151"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1777 MADISON ST",
            "city": "CLARKSVILLE",
            "state": "TN",
            "postal_code": "370434909",
            "telephone_number": "931-202-9151"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "114 Altama Connector",
            "address_purpose": "LOCATION",
            "city": "Brunswick",
            "state": "GA",
            "postal_code": "315251891",
            "country_code": "US",
            "telephone_number": "912-262-6688",
            "fax_number": "912-264-2409",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEE",
        "first_name": "JA EUN",
        "name_prefix": "Dr.",
        "credential": "D.D.S",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-06-28",
        "last_updated": "2024-03-14",
        "certification_date": "2024-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WI",
            "license": "6737-015",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "GA",
            "license": "DN014745",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TN",
            "license": "0000011751",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JAJA",
            "last_name": "LEE",
            "prefix": "DR.",
            "credential": "D.D.S",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Brittney Lee
• Casey Lee
• George S. Lee, MD, DDS
• Grace Lee, DMD
• Hallie Lee
• Laura Lee, M.S., CCC-SLP
• Leara Lee
• Lisa Nicole Lee
• Su Jin Lee, M.S., CCC-SLP
• Jennifer Dawn Leeper, LPC

• General Practice Dentistry in Clarksville, TN
• Providers in Clarksville, TN by specialty
• General Practice Dentistry in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.