Jennie Lee

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

22DI02639605 Issued in NJ

Practice address

1130 Raritan Rd Ste 1
Cranford, NJ 07016-3378

Phone

(908) 418-4215

NPI assigned

Apr 24, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Jul 8, 2022 through Jul 8, 2028

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1429833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583193600000",
    "number": "1851788012",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1130 RARITAN RD STE 1",
            "city": "CRANFORD",
            "state": "NJ",
            "postal_code": "070163378",
            "telephone_number": "908-418-4215"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1130 RARITAN RD STE 1",
            "city": "CRANFORD",
            "state": "NJ",
            "postal_code": "070163378",
            "telephone_number": "908-418-4215"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "110 Bergen St.",
            "address_2": "Room D716",
            "address_purpose": "LOCATION",
            "city": "Newark",
            "state": "NJ",
            "postal_code": "071011709",
            "country_code": "US",
            "telephone_number": "973-972-4621",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEE",
        "first_name": "JENNIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-04-24",
        "last_updated": "2020-03-03",
        "certification_date": "2020-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "NJ",
            "license": "22DI02639605",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michele Latempa, OTR
• Shauna Lawlor, PT, DPT
• Jessica Lawrence
• Megan Lawton
• Eugene Lee, PT, DPT
• Bernard Joel Lehrhoff, M.D.
• Trina Lewin, M.S.W.
• Jessica L Lewis-Styler, M.A. CCC-SLP
• Sheyenne Lewis, OTD
• Keith Lewkowitz, M.A.

• Pediatric Dentistry in Cranford, NJ
• Providers in Cranford, NJ by specialty
• Pediatric Dentistry in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2020; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.