Individual provider Active NPI

Alexander Lezhansky, D.D.S

  • General Practice Dentistry
  • Brooklyn, NY
National Provider Identifier
1972640050
Registry record updated Mar 14, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
052119 Issued in NY
Practice address
3060 Ocean Ave
Ste LN
Brooklyn, NY 11235-3354
Phone
(718) 615-2272
NPI assigned
Jan 30, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 14, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 052119 NY Primary

Addresses

Primary practice location

3060 Ocean Ave
Ste LN
Brooklyn, NY 11235-3354

Mailing address

3060 Ocean Ave
Ste LN
Brooklyn, NY 11235-3354
Phone (718) 615-2272

Other identifiers 1

IdentifierTypeStateIssuer
02662999MedicaidNY

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
I20161025001736 NY Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 4284912320

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Healthy Teeth Dental PC 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": "1170115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1489449600000",
    "number": "1972640050",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3060 OCEAN AVE",
            "address_2": "STE LN",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112353354",
            "telephone_number": "718-615-2272"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3060 OCEAN AVE",
            "address_2": "STE LN",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112353354",
            "telephone_number": "718-615-2272"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEZHANSKY",
        "first_name": "ALEXANDER",
        "name_prefix": "Dr.",
        "credential": "D.D.S",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-30",
        "last_updated": "2017-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "052119",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02662999",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.