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SO JUNG LEE D.M.D.
NPI 1821612904
Dentist - General Practice in Centreville, VA

Active since June 03, 2020PECOS Enrolled
13880 BRADDOCK RD STE 109, CENTREVILLE, VA 20121(703) 830-9990 Get Directions Write a Review

NPPES record last updated: April 22, 2022. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Apr 22, 2022, May 25, 2021, Dec 14, 2020 and 1 more (4 updates tracked since 2020).

About So Jung Lee D.m.d. NPPES

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

SO JUNG LEE D.M.D. (NPI 1821612904) is an individual general practice provider in Centreville, Virginia, licensed in Virginia (0401417223) and active in the NPI registry since June 2020. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1821612904
Entity TypeIndividualFemale
Primary Taxonomy1223G0001X
Provider Legal NameSO JUNG LEECredential: D.M.D.
Location Address13880 BRADDOCK RD STE 109Centreville, VA 20121-2460
Mailing Address9450 Fairfax Blvd Apt 1504Fairfax, VA 22031-2422 · (703) 969-4878
Phone(703) 830-9990
Sole ProprietorNo
Enumeration DateJune 3, 2020
Last NPPES UpdateApril 22, 20224 updates tracked since enumeration
NPPES CertifiedApril 22, 2022
✔ NPI 1821612904 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · General PracticeDental Providers
Taxonomy Code1223G0001X
Licenses✔ Licensed in VA · 0401417223✔ Licensed in OH · 30.026164
Definition
A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.
13880 BRADDOCK RD STE 109, Centreville, VA 20121
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter from Meridian, Ambetter Health and more.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)

So Jung Lee D.m.d. 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 20121 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
$100.31 typical visit price
range $65.18 – $194.86
Typical copayment $25.07 (range $16.29 – $48.71)
Most-billed visit code 99203
Established Patient
$80.66 typical visit price
range $21.40 – $158.88
Typical copayment $20.16 (range $5.35 – $39.72)
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 4

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

ANIQA ZAHEER HO 1
Dentist (General Practice)
13880 BRADDOCK RD STE 109
CENTREVILLE, VA 20121
Fairfax County (703) 830-9990
ANIQA ZAHEER DDS PLLC
Clinic/Center (Dental)
13880 BRADDOCK RD STE 109
CENTREVILLE, VA 20121
Fairfax County (703) 830-9990
ANIQA ZAHEER DDS PLLC
Clinic/Center (Dental)
13880 BRADDOCK RD STE 109
CENTREVILLE, VA 20121
Fairfax County (703) 830-9990
DOANTRANG T NGUYEN DDS
Dentist
13880 BRADDOCK RD STE 109
CENTREVILLE, VA 20121
Fairfax County (703) 893-6680

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 So Jung Lee's NPI number?

The NPI number for So Jung Lee is 1821612904. It was assigned to this individual provider in the NPPES registry on June 3, 2020.

Where is So Jung Lee located?

So Jung Lee practices at 13880 Braddock Rd Ste 109, Centreville, VA 20121. The listed phone number is (703) 830-9990.

What is So Jung Lee's specialty?

The primary specialty registered for this NPI is Dentist, specializing in General Practice, with taxonomy code 1223G0001X.

Is So Jung Lee enrolled in Medicare?

Yes. So Jung Lee is registered in the Medicare PECOS enrollment system.

What insurance does So Jung Lee accept?

Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Meridian, Anthem Blue Cross and Blue Shield and BEST Life and 9 other insurers list So Jung 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 So Jung Lee was last updated on April 22, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.