Active NPI
Gajin Lee
- General Practice Dentistry
- Jacksonville, NC
National Provider Identifier
1689377483
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 14331
- Practice address
- 461 Western Blvd Ste 104
Jacksonville, NC 28546-7637 - Phone
- (910) 346-2202
- NPI assigned
- Mar 22, 2023
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 14331 | NC | Primary |
Addresses
Primary practice location
461 Western Blvd Ste 104
Jacksonville, NC 28546-7637
Mailing address
5079 Western Blvd Apt 3F
Jacksonville, NC 28546-7187
Phone (551) 404-8394
Other practice location 1
622 W 168th St
New York, NY 10032-3720
Phone (212) 305-6100
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 |
|---|---|---|---|
| 14331 | NC | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1679443200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1752278400000",
"number": "1689377483",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5079 WESTERN BLVD APT 3F",
"city": "JACKSONVILLE",
"state": "NC",
"postal_code": "285467187",
"telephone_number": "551-404-8394"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "461 WESTERN BLVD STE 104",
"city": "JACKSONVILLE",
"state": "NC",
"postal_code": "285467637",
"telephone_number": "910-346-2202"
}
],
"practiceLocations": [
{
"address_1": "622 W 168th St",
"address_purpose": "LOCATION",
"city": "New York",
"state": "NY",
"postal_code": "100323720",
"country_code": "US",
"telephone_number": "212-305-6100",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "LEE",
"first_name": "GAJIN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-03-22",
"last_updated": "2025-07-12",
"certification_date": "2025-07-12",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "NC",
"license": "14331",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Jacksonville, NC
- Lechris Health Systems of Jacksonville, Inc.
- Lechris Health Systems of Jacksonville, Inc.
- Lechris Health Systems of Jacksonville, Inc.
- Lechris Health Systems of Jacksonville, Inc.
- Diane Cathleen Lee, PSY.D.
- Tida Kumbalasiri Lee, M.D., PH.D.
- Candace Doerfler Leggett, P.T.
- Robert Michael Lenn, RN
- Sean Patrick Leonard, M.D.
- Khye Sheng Andrei Leong, M.D.
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 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.