MEDICARE: DR. DAVID JACK LESANSKY D.M.D.

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	122300000X	Dentist	8903	NC

General Provider Information

NPI Number	:	1871604389
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DAVID JACK LESANSKY D.M.D.

Provider Business Mailing Address
First Line	:	90 CYPRESS WAY E
Second Line	:	#20
City	:	NAPLES
State	:	FL
Zip	:	34110-9275
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	8401 UNIVERSITY EXEC PARK DR STE 110
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28262-1360
Country	:	US
Telephone Number	:	704-547-1970
Fax Number	:

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

Provider Enumeration Date	:	08/31/2006
Last Update Date	:	12/16/2025

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