Provider Demographics
NPI:1518643147
Name:STEPHEN, LESLEY-ANN J (DDS)
Entity Type:Individual
Prefix:DR
First Name:LESLEY-ANN
Middle Name:J
Last Name:STEPHEN
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 1:8601 CLARIDGE DR
Mailing Address - Street 2:
Mailing Address - City:MIRAMAR
Mailing Address - State:FL
Mailing Address - Zip Code:33025-2720
Mailing Address - Country:US
Mailing Address - Phone:954-982-1610
Mailing Address - Fax:
Practice Address - Street 1:5607 NW 27TH AVE
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33142-2826
Practice Address - Country:US
Practice Address - Phone:305-805-1700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-27
Last Update Date:2023-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program