Provider Demographics
NPI:1972640050
Name:LEZHANSKY, ALEXANDER (DDS)
Entity Type:Individual
Prefix:DR
First Name:ALEXANDER
Middle Name:
Last Name:LEZHANSKY
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 1:3060 OCEAN AVE
Mailing Address - Street 2:STE LN
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11235-3354
Mailing Address - Country:US
Mailing Address - Phone:718-615-2272
Mailing Address - Fax:
Practice Address - Street 1:3060 OCEAN AVE
Practice Address - Street 2:STE LN
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11235-3354
Practice Address - Country:US
Practice Address - Phone:718-615-2272
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-30
Last Update Date:2017-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0521191223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02662999Medicaid