Individual provider Active NPI

Jina Lee

  • General Practice Dentistry
  • Lilburn, GA
National Provider Identifier
1861310237
Registry record updated Jul 10, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DN124204 Issued in GA
Practice address
609 Beaver Ruin Rd NW Ste a
Lilburn, GA 30047-3401
Phone
(770) 925-3300
NPI assigned
Jul 6, 2026
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 10, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DN124204 GA Primary

Addresses

Primary practice location

609 Beaver Ruin Rd NW Ste a
Lilburn, GA 30047-3401

Mailing address

5171 Glade Park Dr
Lilburn, GA 30047-2300
Phone (404) 984-8251

Other practice location 1

1152 Auburn Rd Ste 101
Dacula, GA 30019-5445
Phone (770) 925-3300

Other practice location 2

6460 Spalding Dr Ste C2nd
Peachtree Corners, GA 30092-1807
Phone (770) 925-3300

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

NPI Registry JSON

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

{
    "created_epoch": "1783296000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783641600000",
    "number": "1861310237",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5171 GLADE PARK DR",
            "city": "LILBURN",
            "state": "GA",
            "postal_code": "300472300",
            "telephone_number": "404-984-8251"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "609 BEAVER RUIN RD NW STE A",
            "city": "LILBURN",
            "state": "GA",
            "postal_code": "300473401",
            "telephone_number": "770-925-3300"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1152 Auburn Rd Ste 101",
            "address_purpose": "LOCATION",
            "city": "Dacula",
            "state": "GA",
            "postal_code": "300195445",
            "country_code": "US",
            "telephone_number": "770-925-3300",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6460 Spalding Dr Ste C2nd",
            "address_purpose": "LOCATION",
            "city": "Peachtree Corners",
            "state": "GA",
            "postal_code": "300921807",
            "country_code": "US",
            "telephone_number": "770-925-3300",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEE",
        "first_name": "JINA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2026-07-06",
        "last_updated": "2026-07-10",
        "certification_date": "2026-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "GA",
            "license": "DN124204",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lilburn, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2026; 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.