MEDICARE: DR. NATALYA LESNIKOVSKAYA D.D.S.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	54853	CA
2	1223G0001X	General Practice Dentistry	37950	TX

General Provider Information

NPI Number	:	1760517189
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. NATALYA LESNIKOVSKAYA D.D.S.

Provider Business Mailing Address
First Line	:	1515 N TOWN EAST BLVD
Second Line	:
City	:	MESQUITE
State	:	TX
Zip	:	75150-4157
Country	:	US
Telephone Number	:	972-686-1955
Fax Number	:	972-686-1955

Provider Business Practice Location Address
First Line	:	1515 N TOWN EAST BLVD
Second Line	:
City	:	MESQUITE
State	:	TX
Zip	:	75150-4157
Country	:	US
Telephone Number	:	972-686-1955
Fax Number	:	972-686-0926

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/23/2007
Last Update Date	:	11/10/2021

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