Jason Lee, D.D.S.

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

DN18554 Issued in FL

Practice address

4257 Point la Vista Rd W
Jacksonville, FL 32207-6247

Phone

(904) 703-2236

NPI assigned

Dec 8, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in FL

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.

• Advanced Maxillofacial Surgical LLC

  • Oral and Maxillofacial Surgery (Dentist)
  • Jacksonville, FL
  • NPI 1821404914
  NPD Authorized official
• Oral & Facial Surgery Center of Tallahassee, P.a.

  • Oral and Maxillofacial Surgery (Dentist)
  • Tallahassee, FL
  • NPI 1306172143
  NPD (past)
• Oral and Facial Surgery Center of Tallahassee

  • Oral and Maxillofacial Surgery (Dentist)
  • Tallahassee, FL
  • NPI 1770776155
  NPD (past)

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

{
    "created_epoch": "1165536000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736208000000",
    "number": "1578622908",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4257 POINT LA VISTA RD W",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322076247",
            "telephone_number": "904-703-2236"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4257 POINT LA VISTA RD W",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322076247",
            "telephone_number": "904-703-2236"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "JASON",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-08",
        "last_updated": "2025-01-07",
        "certification_date": "2025-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "FL",
            "license": "DTP477",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "AZ",
            "license": "D7521",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "FL",
            "license": "DN18554",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "461503733A",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0767638-00",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Gary Lee, MD
• Hazel A Lee, LMT
• Helen Lee, AU.D.
• Holly Lee
• Irene Timothy Lee, MD
• Jennifer Lynn Lee
• Joseph King Lee, DMD
• Juliet Lee, OT
• Kendra Gray Lee
• Kia Lee

• Oral and Maxillofacial Surgery (Dentist) in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Oral and Maxillofacial Surgery (Dentist) in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2025; 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.