Provider Demographics
NPI:1598915506
Name:SHEMET, LEA MARIE (DDS)
Entity Type:Individual
Prefix:DR
First Name:LEA
Middle Name:MARIE
Last Name:SHEMET
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:PO BOX 5560
Mailing Address - Street 2:
Mailing Address - City:MILLER PLACE
Mailing Address - State:NY
Mailing Address - Zip Code:11764-1204
Mailing Address - Country:US
Mailing Address - Phone:631-928-1278
Mailing Address - Fax:631-928-2879
Practice Address - Street 1:254 N COUNTRY RD
Practice Address - Street 2:
Practice Address - City:MILLER PLACE
Practice Address - State:NY
Practice Address - Zip Code:11764-2302
Practice Address - Country:US
Practice Address - Phone:631-928-1278
Practice Address - Fax:631-928-2879
Is Sole Proprietor?:No
Enumeration Date:2008-09-25
Last Update Date:2008-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0439461223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice