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Jacob Lee, DMD, MD — NPI 1912438805, Fayetteville, GA | NPI Central

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NPI 1912438805

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Jacob Lee, DMD, MD

NPI 1912438805 · Oral & Maxillofacial Surgery (D.M.D.) · Fayetteville, GA

Provider details

NPI number: 1912438805
Entity type: Individual
Primary specialty: Oral & Maxillofacial Surgery (D.M.D.)Allopathic & Osteopathic Physicians
Credential: DMD, MD
Sex: Male
Sole proprietor: No
License: 94785 (GA)

Specialties & taxonomies

Oral & Maxillofacial Surgery (D.M.D.)Primary204E00000XLicense 94785 (GA)
Allopathic & Osteopathic Physicians
Oral and Maxillofacial Surgery (Dentist)1223S0112XLicense DN122602 (GA)
Dental Providers

Practice location

1260 Highway 54 Ste 200

Fayetteville, GA 30214-4513

Phone: (770) 461-2101

Approximate (ZIP-level) locationGet directions

More GA providers

Mailing address

2593 Brookline Cir Ne

Brookhaven, GA 30319-3691

Additional practice locations (1)

1825 Highway 34 E Ste 1700
Newnan, GA 30265-6416
Phone: (470) 400-2637

Registry dates

Enumerated: 2017-03-23
Last updated: 2023-08-09
Certified: 2023-08-09

Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.