Provider Demographics
NPI:1881792786
Name:LEPCZYK, JAMES W (DDS)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:W
Last Name:LEPCZYK
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:31100 TELEGRAPH
Mailing Address - Street 2:SUITE 100
Mailing Address - City:BINGHAM FARMS
Mailing Address - State:MI
Mailing Address - Zip Code:48025
Mailing Address - Country:US
Mailing Address - Phone:248-642-2115
Mailing Address - Fax:248-642-6387
Practice Address - Street 1:31100 TELEGRAPH
Practice Address - Street 2:SUITE 100
Practice Address - City:BINGHAM FARMS
Practice Address - State:MI
Practice Address - Zip Code:48025
Practice Address - Country:US
Practice Address - Phone:248-642-2115
Practice Address - Fax:248-642-6387
Is Sole Proprietor?:No
Enumeration Date:2006-09-21
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MI11914204E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes204E00000XAllopathic & Osteopathic PhysiciansOral & Maxillofacial Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1246219Medicaid
5636880Medicare ID - Type Unspecified
T82870Medicare UPIN