MEDICARE: LUCID DENTAL LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry

General Provider Information

NPI Number	:	1477417467
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LUCID DENTAL LLC

Provider Business Mailing Address
First Line	:	105 PROFESSIONAL CT SE
Second Line	:
City	:	CALHOUN
State	:	GA
Zip	:	30701-7036
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	105 PROFESSIONAL CT SE
Second Line	:
City	:	CALHOUN
State	:	GA
Zip	:	30701-7036
Country	:	US
Telephone Number	:	917-745-2019
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	JAE WOO LEE
Credential	:	DDS
Telephone Number	:	917-745-2019

Provider Enumeration Date	:	12/12/2025
Last Update Date	:	03/17/2026

Similar Medicare Providers

1548990005 — JAE WOO LEE
Practice Location Address:

105 PROFESSIONAL CT SE
CALHOUN, GA
30701-7036

Practice Phone: 917-745-2019
Practice Fax:

1346422995 — NORTH GEORGIA UROLOGY GROUP, P.C.
Practice Location Address:

101 PROFESSIONAL CT SE
CALHOUN, GA
30701-7036

Practice Phone: 706-625-3822
Practice Fax: 706-625-8030

1154555035 — DR. SALAM OMAR SALMAN M.D., D.D.S
Practice Location Address:

117 PROFESSIONAL CT SE
CALHOUN, GA
30701-7036

Practice Phone: 706-629-5200
Practice Fax:

1023522950 — IN MOTION CHIROPRACTIC, LLC
Practice Location Address:

110 N WALL ST
CALHOUN, GA
30701-2242

Practice Phone: 706-629-7349
Practice Fax:

1316472798 — DR. JAMIE FOLDS DC
Practice Location Address:

110 N WALL ST
CALHOUN, GA
30701-2242

Practice Phone: 706-629-7349
Practice Fax:

1932030624 — AUDREY MARGARET MCFALL
Practice Location Address:

1114 S WALL ST
CALHOUN, GA
30701-3062

Practice Phone: 770-207-6390
Practice Fax: 678-374-4855

Directions to “LUCID DENTAL LLC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.