Provider Demographics
NPI:1437377926
Name:LESEM, DEBORAH ELAINE (DDS)
Entity Type:Individual
Prefix:DR
First Name:DEBORAH
Middle Name:ELAINE
Last Name:LESEM
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:774 TOPAZ ST
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70124-3624
Mailing Address - Country:US
Mailing Address - Phone:504-286-1489
Mailing Address - Fax:
Practice Address - Street 1:4036 CANAL ST
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70119-6021
Practice Address - Country:US
Practice Address - Phone:504-488-4110
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA4632122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist