Individual provider Active NPI

Lisa Marie Leniski, D.D.S., M.S.D.

  • Pediatric Dentistry
  • Michigan City, IN
National Provider Identifier
1093849424
Registry record updated Sep 7, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
12010935A Issued in IN
Practice address
211 E 4TH St
Michigan City, IN 46360-3364
Phone
(219) 879-4559
Fax
(219) 879-4559
NPI assigned
Mar 15, 2007
Last updated
Sep 7, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 7, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Dentistry 1223P0221X 12010935A IN Primary

Addresses

Primary practice location

211 E 4TH St
Michigan City, IN 46360-3364

Mailing address

211 E 4TH St
Michigan City, IN 46360-3364
Phone (219) 879-4559

Other identifiers 1

IdentifierTypeStateIssuer
201036320MedicaidIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
12010935AINMDPediatric Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
Lisa Leniski, DDS, MSD, LLC Pediatric Dentistry Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: lleniski179110@direct.franciscanalliance.org

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1173916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1473206400000",
    "number": "1093849424",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "211 E 4TH ST",
            "city": "MICHIGAN CITY",
            "state": "IN",
            "postal_code": "463603364",
            "telephone_number": "219-879-4559",
            "fax_number": "219-879-4559"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "211 E 4TH ST",
            "city": "MICHIGAN CITY",
            "state": "IN",
            "postal_code": "463603364",
            "telephone_number": "219-879-4559",
            "fax_number": "219-879-4559"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LENISKI",
        "first_name": "LISA",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "D.D.S., M.S.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-15",
        "last_updated": "2016-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "IN",
            "license": "12010935A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201036320",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Michigan City, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.