DR. JASON LEE (NPI# 1578622908) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1578622908 |
| Entity Type | Individual |
| Full Name | DR. JASON LEE |
| Credential | D.D.S. |
| Practice Address |
13820 Old St Augustine Rd Suite 105 Jacksonville FL 32258 |
| Mailing Address |
3263 Gramercy Pl Tallahassee FL 32308-0581 |
| Practice Telephone | 9042607700 |
| Enumeration Date | 2006-12-08 |
| Last Update Date | 2012-10-19 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223S0112X |
Dentist Specialization: Oral and Maxillofacial Surgery |
DN18554 | FL | Dental Providers |
| N | 1223S0112X |
Dentist Specialization: Oral and Maxillofacial Surgery |
D7521 | AZ | Dental Providers |
| N | 1223S0112X |
Dentist Specialization: Oral and Maxillofacial Surgery |
DTP477 | FL | Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | 0767638-00 | 05 | |
| GA | 461503733A | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760080378 | Jason Lee | Physician Assistant | 42 Electric Ave, Somerville, MA 02144-1604 | 2020-10-15 |
| 1205398021 | Jason Lee | Student in an Organized Health Care Education/Training Program | 40 Sunshine Cottage Rd Ste 2n-b24, Valhalla, NY 10595-1524 | 2019-04-01 |
| 1063920858 | Jason Jung Lee | Dentist | 2486 W El Camino Real, Mountain View, CA 94040-1421 | 2018-01-16 |
| 1831600998 | Jason Yoonhyung Lee | Psychologist | 615 Seabright Ln, Solana Beach, CA 92075-1264 | 2017-10-17 |
| 1033633060 | Jason J Lee | Chiropractor | 12225 South St Ste 106, Artesia, CA 90701-7047 | 2017-08-01 |
| 1487188629 | Jason P Lee | Specialist | 14445 Olive View Dr # H1, Sylmar, CA 91342-1437 | 2017-04-14 |
| 1396088233 | Jason Lee | Anesthesiology | 141 E 3rd St Apt 10c, New York, NY 10009-7309 | 2013-03-28 |
| 1679817431 | Jason M Lee | Pharmacist | 2939 Hylan Blvd, Staten Island, NY 10306-4057 | 2012-11-19 |
| 1770848046 | Jason Lee | Dentist | 9738 Katy Fwy Ste 400, Houston, TX 77055-6214 | 2012-07-11 |
| 1407111339 | Jason Daniel Lee | Family Medicine | 8150 Oaklandon Rd Ste 130, Indianapolis, IN 46236-9554 | 2012-07-06 |
| Street Address |
13820 OLD ST AUGUSTINE RD SUITE 105 |
| City | JACKSONVILLE |
| State | FL |
| Zip Code | 32258 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659587715 | James Brandon Bennett | Dentist | 13820 Old St Augustine Rd, Jacksonville, Jacksonville, FL 32258-5424 | 2007-05-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437794237 | Nicoleta Descalzo | Behavior Technician | 12724 Grand Bay Parkway West, Suite 410, Jacksonville, FL 32258 | 2019-11-15 |
| 1992275572 | William Lundgren | Nurse Anesthetist, Certified Registered | 3625 University Blvd South, Jacksonville, FL 32258 | 2018-11-27 |
| 1104301159 | Emergency Physicians Inc | Emergency Medicine | 14534 Old St Augustine Rd, Suite 3110, Jacksonville, FL 32258 | 2018-09-26 |
| 1679092886 | Palm Life Medical Associates Pa | Assisted Living Facility | 12494 Acosta Oaks Drive, Jacksonville, FL 32258 | 2017-09-19 |
| 1679013932 | Optometry Vision Care Pllc | Optometrist | 14866 Old St. Augustine Rd Unit 110, Jacksonville, FL 32258 | 2017-03-06 |
| 1467991950 | North Florida Vision Group Inc | Optometrist | 14866 Old St. Augustine Rd., Suite 110, Jacksonville, FL 32258 | 2017-02-16 |
| 1124576566 | Revolution Chiropractic LLC | Chiropractor | 14866 Old St Augustine Road, Suite 113, Jacksonville, FL 32258 | 2016-09-14 |
| 1396291936 | Robyn Reaves | Nurse Practitioner | 12361 Richards Glen Ct, Jacksonville, FL 32258 | 2016-09-01 |
| 1326595927 | Lauren Cost | Chiropractor | 14866 Old St. Augustine Road, Suite 113, Jacksonville, FL 32258 | 2016-09-01 |
| 1487991170 | Mark Steven Colosimo | Pharmacist | 13820 Old St Augustine Road, Jacksonville, FL 32258 | 2013-01-15 |
| Find all providers in zip 32258 | ||||
| Taxonomy Code | 1223S0112X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Oral and Maxillofacial Surgery |
| The specialty of dentistry which includes the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154760411 | Tyler J Holley | Dentist | University of Florida- Jacksonville, 653-1 West 8th Street, Jacksonville, FL 32209 | 2013-06-20 |
| 1851602734 | Carlo Enrico Guevara | Dentist | 4540 Southside Blvd Ste 1001, Jacksonville, FL 32216-5495 | 2010-06-25 |
| 1306073754 | Bouali Frederick Amoli | Dentist | 5149 Normandy Blvd Unit 4, Jacksonville, FL 32205-4861 | 2009-06-12 |
| 1154555035 | Salam Omar Salman | Dentist | 653 W. 8th Street, Uf - Jacksonville Dept. of Oral & Maxillofacial Surgery, Jacksonville, FL 32209 | 2009-05-07 |
| 1316151301 | Scott Roberts Sklenicka | Dentist | 2511 Saint Johns Bluff Rd S, Suite 207, Jacksonville, FL 32246-2346 | 2007-05-09 |
| 1851417406 | North Florida Oral & Facial Surgery, P.a. | Dentist | 11481 Old Saint Augustine Rd Ste 203, Jacksonville, FL 32258-1475 | 2007-03-22 |
| 1992832059 | Vanni Russ Strenta | Dentist | 3914 Blanding Blvd, Jacksonville, FL 32210-5413 | 2007-02-27 |
| 1184760480 | Gregory Joseph Groshan | Dentist | 3007 Hartley Rd, Jacksonville, FL 32257-6201 | 2007-01-30 |
| 1477606267 | Gregory W Hartley | Dentist | 4181 Southpoint Dr E, Suite 200, Jacksonville, FL 32216-0993 | 2007-01-18 |
| 1366591265 | Pairot Tayapongsak | Dentist | 7101 Normandy Blvd, Jacksonville, FL 32205-6211 | 2007-01-09 |
| Find all providers in JACKSONVILLE | ||||
| City | JACKSONVILLE |
| Zip Code | 32258 |
Please comment or provide details below to improve the information on DR. JASON LEE.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.