Individual provider

So Jung Lee, D.M.D.

General Practice Dentistry Medicare enrolled

So Jung Lee, D.M.D. is a provider specialising in General Practice Dentistry in Centreville, VA, registered under NPI 1821612904.

Getting there

The practice address on file is 13880 BRADDOCK RD STE 109, Centreville, VA 20121. We have not yet mapped what surrounds this office — parking, transit, and nearby pharmacies are added as our data collection reaches each location.

13880 BRADDOCK RD STE 109, Centreville, VA 20121 Open in Google Maps →

Credentials and Medicare

State licence
LicenceStateSpecialty
0401417223 VA General Practice Dentistry primary
30.026164 OH General Practice Dentistry

Licences are recorded in 2 states: VA, OH. Providers licensed in several states often practise near a state border or deliver telehealth across state lines.

Medicare (PECOS)
Status
Approved
Provider type
Order And Referring Only - Dentist
PAC ID
5698198836
Enrollment ID
I20200707002529

Medicare enrolment is recorded as approved under the provider type Order And Referring Only - Dentist. Being enrolled means the provider can bill Medicare; it does not tell you whether they are currently accepting new Medicare patients. Call the office to confirm.

Licensed in 2 states

This provider holds licences in 2 states: Ohio and Virginia. The practice address on file is in Centreville, VA, but a licence in another state usually means they see patients there too — either at a second location or by telehealth. If the address above is far from you, it is worth calling to ask whether they practise closer to where you live.

OH Ohio
Licence
30.026164
Specialty
General Practice Dentistry
Verify with the OH board →
VA Virginia practice address
Licence
0401417223
Specialty
General Practice Dentistry
Verify with the VA board →

Licence numbers are self-reported to NPPES at registration. They do not confirm a licence is currently active, in good standing, or valid for the specialty shown — only the state board can tell you that, which is why we link to each one.

What General Practice covers

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. NUCC Health Care Provider Taxonomy, code 1223G0001X
Dental Providers Dentist General Practice

All registered taxonomy codes

This provider registers 2 taxonomy codes. The primary code is what appears on most claims; the others record additional recognised specialties.

CodeSpecialtyLicenceState
1223G0001X General Practice Dentistry General Practice 0401417223 VA primary
1223G0001X General Practice Dentistry General Practice 30.026164 OH

The taxonomy records how the provider classifies their own practice. It does not confirm which conditions they currently treat, whether they are accepting new patients, or which insurance they take — call the office for that.

Full NPPES record

An NPI-1 identifies a single person. It stays with the clinician for life, even if they move practice or change state, which is why the address on file can lag behind where they actually work today.

NPI1821612904 valid check digit
Entity typeIndividual (NPI-1)
Enumeration dateJun 3, 2020
Last updatedApr 22, 2022
StatusActive
Sole proprietorNo
CredentialD.M.D.
Practice address 13880 BRADDOCK RD STE 109
Centreville, VA 20121
(703) 830-9990
Mailing address 9450 FAIRFAX BLVD APT 1504
Fairfax, VA 22031
The last update on file is Apr 22, 2022. Providers are only required to update NPPES when their information changes, so an older date does not necessarily mean the details are wrong — but it is worth a quick call before you travel.

Number check

1821612904 passes the NPI check digit test The final digit 4 matches the value computed from the first nine digits, so this is a well-formed NPI.
How the check works, step by step

Every NPI carries a Luhn check digit — the same scheme used on credit cards. CMS prefixes the number with 80840 before computing it, which marks it as a US health identifier.

Digit 8 0 8 4 0 1 8 2 1 6 1 2 9 0
Doubled? ×2 ×2 ×2 ×2 ×2 ×2 ×2
Value 8 0 8 8 0 2 8 4 1 3 1 4 9 0

Sum = 56 · next multiple of 10 = 60 · check digit = 4 · actual last digit = 4

A valid check digit only means the number is well-formed. It does not mean the provider is licensed, active, or in good standing — those are separate questions answered by the sections above.

Common questions

What is NPI number 1821612904?
NPI 1821612904 is the National Provider Identifier assigned to So Jung Lee, D.M.D. in Centreville, VA. It is a 10-digit number issued by the Centers for Medicare & Medicaid Services and used on claims, referrals, and prescriptions to identify the provider.
What does General Practice cover?
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.
How do I contact So Jung Lee, D.M.D.?
The phone number on file with NPPES is (703) 830-9990, last updated Apr 22, 2022. Because NPPES is only updated when a provider files a change, call ahead to confirm the number and the current practice address before visiting.
Does So Jung Lee, D.M.D. accept Medicare?
This NPI has an approved Medicare enrolment in PECOS, which means the provider is enrolled to bill Medicare. Enrolment does not guarantee they are accepting new Medicare patients — verify directly with the office.
Is NPI 1821612904 a valid number?
Yes. 1821612904 passes the Luhn check digit validation that CMS uses for NPI numbers, and it resolves to an active record in the registry.
How to use this page. Everything here comes from public federal records. Tips Health does not verify quality of care, confirm that a licence is currently active, or check malpractice history, and accepts no fees for placement. A listing is not a recommendation. Verify independently before seeking care.