Individual provider Active NPI

Valentin Lezhansky, DDS

  • Dentist
  • Brooklyn, NY
National Provider Identifier
1497861546
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
038006 Issued in NY
Practice address
3060 Ocean Ave
#LN
Brooklyn, NY 11235
Phone
(718) 615-2272
Fax
(718) 615-0957
NPI assigned
Aug 22, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 038006 NY Primary

Addresses

Primary practice location

3060 Ocean Ave
#LN
Brooklyn, NY 11235

Mailing address

3060 Ocean Ave
#LN
Brooklyn, NY 11235
Phone (718) 615-2272

Other identifiers 1

IdentifierTypeStateIssuer
00804408MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161208000567 NY Order and Referring Only - DentistPractitioner - Dentist 6406136456

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
038006NYMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Healthy Teeth Dental PC Dentist Past Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1156204800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1497861546",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3060 OCEAN AVE",
            "address_2": "#LN",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "11235",
            "telephone_number": "718-615-2272",
            "fax_number": "718-615-0957"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3060 OCEAN AVE",
            "address_2": "#LN",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "11235",
            "telephone_number": "718-615-2272",
            "fax_number": "718-615-0957"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEZHANSKY",
        "first_name": "VALENTIN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-22",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "038006",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00804408",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.