Healthcare Provider Details

I. General information

NPI: 1871604389
Provider Name (Legal Business Name): DAVID JACK LESANSKY D.M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/31/2006
Last Update Date: 12/16/2025
Certification Date: 12/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8401 UNIVERSITY EXEC PARK DR STE 110
CHARLOTTE NC
28262-1360
US

IV. Provider business mailing address

90 CYPRESS WAY E #20
NAPLES FL
34110-9275
US

V. Phone/Fax

Practice location:
  • Phone: 704-547-1970
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number8903
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: