Provider Demographics
NPI:1215956628
Name:LEE, JASON J (DDS)
Entity type:Individual
Prefix:DR
First Name:JASON
Middle Name:J
Last Name:LEE
Suffix:
Gender:
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:270 CORNERSTONE DR STE 104
Mailing Address - Street 2:
Mailing Address - City:CARY
Mailing Address - State:NC
Mailing Address - Zip Code:27519-8400
Mailing Address - Country:US
Mailing Address - Phone:919-380-7624
Mailing Address - Fax:
Practice Address - Street 1:8282 NC 58 S
Practice Address - Street 2:
Practice Address - City:ELM CITY
Practice Address - State:NC
Practice Address - Zip Code:27822-8079
Practice Address - Country:US
Practice Address - Phone:252-443-7764
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-18
Last Update Date:2025-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD14422122300000X
NC81721223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No122300000XDental ProvidersDentist