Provider Demographics
NPI:1326084401
Name:LESSICK, JAMES E (DDS)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:E
Last Name:LESSICK
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:725 BOARDMAN CANFIELD RD
Mailing Address - Street 2:N2
Mailing Address - City:BOARDMAN
Mailing Address - State:OH
Mailing Address - Zip Code:44512
Mailing Address - Country:US
Mailing Address - Phone:330-726-0120
Mailing Address - Fax:330-726-6122
Practice Address - Street 1:725 BOARDMAN CANFIELD RD
Practice Address - Street 2:N2
Practice Address - City:BOARDMAN
Practice Address - State:OH
Practice Address - Zip Code:44512
Practice Address - Country:US
Practice Address - Phone:330-726-0120
Practice Address - Fax:330-726-6122
Is Sole Proprietor?:No
Enumeration Date:2006-06-20
Last Update Date:2013-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH30016764122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH01470913Medicaid