Provider Demographics
NPI:1598530479
Name:ADAMS, LESLEY BOEH (DMD)
Entity Type:Individual
Prefix:
First Name:LESLEY
Middle Name:BOEH
Last Name:ADAMS
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:LESLEY
Other - Middle Name:ANNE
Other - Last Name:BOEH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DMD
Mailing Address - Street 1:4101 PALOMAR BLVD
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40513-1314
Mailing Address - Country:US
Mailing Address - Phone:859-619-5853
Mailing Address - Fax:
Practice Address - Street 1:800 ROSE ST # D164
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40536-7001
Practice Address - Country:US
Practice Address - Phone:859-323-3368
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-20
Last Update Date:2023-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY7003122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist