Provider Demographics
NPI:1841341344
Name:LEBESSIS, ANGELA C (DDS)
Entity type:Individual
Prefix:DR
First Name:ANGELA
Middle Name:C
Last Name:LEBESSIS
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 1:1400 W 47TH ST STE 8
Mailing Address - Street 2:
Mailing Address - City:LA GRANGE
Mailing Address - State:IL
Mailing Address - Zip Code:60525-6148
Mailing Address - Country:US
Mailing Address - Phone:708-579-1522
Mailing Address - Fax:708-579-1523
Practice Address - Street 1:1400 W 47TH ST STE 8
Practice Address - Street 2:
Practice Address - City:LA GRANGE
Practice Address - State:IL
Practice Address - Zip Code:60525-6148
Practice Address - Country:US
Practice Address - Phone:708-579-1522
Practice Address - Fax:708-579-1523
Is Sole Proprietor?:No
Enumeration Date:2007-01-13
Last Update Date:2023-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL019-025136122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist