Jacqueline Paige Lee, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

0401418472 Issued in VA

Practice address

109 Clearview Rd
Madison Heights, VA 24572-2600

Phone

(434) 929-1400

NPI assigned

Jul 11, 2019

Last updated

May 21, 2025By the provider in NPPES

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

Medicare fee-for-service enrollment

Enrolled in VA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1562803200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747785600000",
    "number": "1790337616",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "134 ELON RD",
            "city": "MADISON HEIGHTS",
            "state": "VA",
            "postal_code": "245722536",
            "telephone_number": "434-929-1400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "109 CLEARVIEW RD",
            "city": "MADISON HEIGHTS",
            "state": "VA",
            "postal_code": "245722600",
            "telephone_number": "434-929-1400"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2501 Capehart Rd",
            "address_purpose": "LOCATION",
            "city": "Offutt AFB",
            "state": "NE",
            "postal_code": "681131043",
            "country_code": "US",
            "telephone_number": "402-294-3217",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEE",
        "first_name": "JACQUELINE",
        "middle_name": "PAIGE",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-11",
        "last_updated": "2025-05-21",
        "certification_date": "2025-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "DN24308",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "VA",
            "license": "0401418472",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN24308",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brenda Jean Kozak, FNP-C
• Duane Kresge, NP
• L5 Medical Holdings LLC (Pain Care Center)
• Janna Laverdiere, DMD
• Rebecca Ledingham
• Lawrence Little III, CPNP-AC
• Loving Home Healthcare Services LLC
• Madison Heights Eye Care PC Optometrists
• Robert Paul Mahaffy, PT, DPT
• Charles David Manion, PHARMD

• General Practice Dentistry in Madison Heights, VA
• Providers in Madison Heights, VA by specialty
• General Practice Dentistry in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 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.