EOM JI LEE DMD
NPI 1205219318
Dentist in Jeffersonville, IN

Active since July 07, 2015PECOS Enrolled
2760 JEFFERSON CENTRE WAY STE 2, JEFFERSONVILLE, IN 47130(812) 284-2206(812) 284-2216 Get Directions Write a Review

NPPES record last updated: January 18, 2021. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Jan 18, 2021, Oct 8, 2018 (2 updates tracked since 2018).

About Eom Ji Lee Dmd NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

EOM JI LEE DMD (NPI 1205219318) is an individual dentist in Jeffersonville, Indiana, licensed in Indiana (12012839A) and active in the NPI registry since July 2015. She is enrolled in Medicare PECOS and maintains 2 additional practice locations.

NPPES Registry Identity

NPI1205219318
Entity TypeIndividualFemale
Primary Taxonomy122300000X
Provider Legal NameEOM JI LEECredential: DMD
Location Address2760 JEFFERSON CENTRE WAY STE 2Jeffersonville, IN 47130-8266
Mailing Address2760 Jefferson Centre Way Ste 2Jeffersonville, IN 47130-8266 · (812) 284-2206 · Fax (812) 284-2216
Fax(812) 284-2216
Sole ProprietorNo
Enumeration DateJuly 7, 2015
Last NPPES UpdateJanuary 18, 20212 updates tracked since enumeration
NPPES CertifiedJanuary 18, 2021
NPI 1205219318 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyDentistDental Providers
Taxonomy Code122300000X
Licenses Licensed in IN · 12012839A Licensed in KY · 9637
Definition

A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist.

2760 JEFFERSON CENTRE WAY STE 2, Jeffersonville, IN 47130

Secondary Practice Locations 2

Location 1500 Winchester AveAshland, KY 41101-7362 · Phone (606) 618-9963
Location 23438 Taylor BlvdLouisville, KY 40215 · Phone (502) 366-4442 · Fax (502) 366-4446

Accepted Insurance

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Enrolled in Medicare (PECOS)

Eom Ji Lee Dmd is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer Part B Labs & Imaging Durable Medical Equipment Home Health Agency Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 47130 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$82.04 typical visit price
range $53.07 – $161.76
Typical copayment $20.51 (range $13.26 – $40.44)
Most-billed visit code 99203
Established Patient
$66.48 typical visit price
range $16.93 – $132.22
Typical copayment $16.62 (range $4.23 – $33.05)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Dentist (General Practice)
2760 JEFFERSON CENTRE WAY STE 2
JEFFERSONVILLE, IN 47130
Dentist
2760 JEFFERSON CENTRE WAY STE 2
JEFFERSONVILLE, IN 47130
Dentist
2760 JEFFERSON CENTRE WAY STE 2
JEFFERSONVILLE, IN 47130

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Eom Ji Lee's NPI number?

The NPI number for Eom Ji Lee is 1205219318. It was assigned to this individual provider in the NPPES registry on July 7, 2015.

Where is Eom Ji Lee located?

Eom Ji Lee practices at 2760 Jefferson Centre Way Ste 2, Jeffersonville, IN 47130. The listed phone number is (812) 284-2206.

What is Eom Ji Lee's specialty?

The primary specialty registered for this NPI is Dentist with taxonomy code 122300000X.

Is Eom Ji Lee enrolled in Medicare?

Yes. Eom Ji Lee is registered in the Medicare PECOS enrollment system.

What insurance does Eom Ji Lee accept?

Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Home State Health, Ambetter from Meridian and Ambetter of Tennessee and 10 other insurers list Eom Ji Lee as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Eom Ji Lee was last updated on January 18, 2021. NPI Profile syncs with the weekly NPPES data releases published by CMS.