Jason Sangjae Lee, D.D.S.

Primary specialty

DentistTaxonomy code 122300000X

License

100095 Issued in CA

Practice address

7138 Willow St
Sebastopol, CA 95472-4306

Phone

(707) 823-5308

Fax

(707) 823-5256

NPI assigned

Nov 3, 2014

Last updated

Jun 7, 2016By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

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.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• E. Jang Dental Corporation

  • Dentist
  • Sebastopol, CA
  • NPI 1255474946
  NPD (past)

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

{
    "created_epoch": "1414972800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1465257600000",
    "number": "1942605969",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7138 WILLOW ST",
            "city": "SEBASTOPOL",
            "state": "CA",
            "postal_code": "954724306",
            "telephone_number": "707-823-5308",
            "fax_number": "707-823-5256"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7138 WILLOW ST",
            "city": "SEBASTOPOL",
            "state": "CA",
            "postal_code": "954724306",
            "telephone_number": "707-823-5308",
            "fax_number": "707-823-5256"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "JASON",
        "middle_name": "SANGJAE",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-11-03",
        "last_updated": "2016-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IN",
            "license": "12012249A",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "100095",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dawn Larimar, DC
• Nancy Larson
• Martha Lavin, MSW
• Megan Rozenia Lawrence-Ferreira, LMFT
• Mary Lechner, O.D.
• James Andrew Lemesurier, M.D.
• Gillian Lerner, PSYD
• Lesley Cantor a Family Therapy Professional Corporation
• Dana Levandoski, LCSW
• Eileen Patricia Leveckis, AMFT, APCC

• Dentist in Sebastopol, CA
• Providers in Sebastopol, CA by specialty
• Dentist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2016; 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.