=====================================================
General NPI Number Information
=====================================================
NPI Number | 1811052301
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | ALAN B SCHLESINGER DDS
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/26/2006
-----------------------------------------------------
Last Update Date | 07/08/2007
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 5900 SOM CENTER RD SUITE 10
-----------------------------------------------------
City | WILLOUGHBY
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 44094
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 440-951-2246
-----------------------------------------------------
Fax | 440-943-4767
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 5900 SOM CENTER RD SUITE 10
-----------------------------------------------------
City | WILLOUGHBY
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 44094
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 440-951-2246
-----------------------------------------------------
Fax | 440-943-4767
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 122300000X
-----------------------------------------------------
Taxonomy Name | Dentist
-----------------------------------------------------
License Number | OHIO 3020746
-----------------------------------------------------
License Number State | OH
-----------------------------------------------------