NPIMap

Organization Active NPI

Lee D Jess DDS LTD

  • General Practice Dentistry
  • Grand Rapids, MN
National Provider Identifier
1740352608
Registry record updated Jun 10, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
7035 Issued in MN
Legal business name
LEE D JESS DDS LTD
Practice address
501 S Pokegama Ave
Suite 101
Grand Rapids, MN 55744-3838
Phone
(218) 326-3231
Fax
(218) 326-4619
NPI assigned
Nov 15, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2008

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

Authorized official

Name
Dr. Lee Dale Jess, D.D.S.NPI 1285706226
Title
Owner, President
Phone
(218) 326-3231

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 7035 MN Primary

Addresses

Primary practice location

501 S Pokegama Ave
Suite 101
Grand Rapids, MN 55744-3838

Mailing address

501 S Pokegama Ave
Suite 101
Grand Rapids, MN 55744-3838
Phone (218) 326-3231

Other identifiers 1

IdentifierTypeStateIssuer
038015600MedicaidMN

National Provider Directory

National Provider Directory

Locations

501 S Pokegama Ave
Ste 101
Grand Rapids, MN 55744
Phone (218) 326-3231

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1163548800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213056000000",
    "number": "1740352608",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 S POKEGAMA AVE",
            "address_2": "SUITE 101",
            "city": "GRAND RAPIDS",
            "state": "MN",
            "postal_code": "557443838",
            "telephone_number": "218-326-3231",
            "fax_number": "218-326-4619"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 S POKEGAMA AVE",
            "address_2": "SUITE 101",
            "city": "GRAND RAPIDS",
            "state": "MN",
            "postal_code": "557443838",
            "telephone_number": "218-326-3231",
            "fax_number": "218-326-4619"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEE D JESS DDS LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-15",
        "last_updated": "2008-06-10",
        "status": "A",
        "authorized_official_last_name": "JESS",
        "authorized_official_first_name": "LEE",
        "authorized_official_middle_name": "DALE",
        "authorized_official_title_or_position": "OWNER, PRESIDENT",
        "authorized_official_telephone_number": "218-326-3231",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "MN",
            "license": "7035",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "038015600",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Rapids, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.