MEDICARE: MICHAEL JOHN LESNIANSKI

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	063132	NY
2	122300000X	Dentist	22DI03000001	NJ

General Provider Information

NPI Number	:	1396400701
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHAEL JOHN LESNIANSKI

Provider Business Mailing Address
First Line	:	96 PLAINFIELD AVE
Second Line	:
City	:	EDISON
State	:	NJ
Zip	:	08817-3712
Country	:	US
Telephone Number	:	347-422-7645
Fax Number	:

Provider Business Practice Location Address
First Line	:	96 PLAINFIELD AVE
Second Line	:
City	:	EDISON
State	:	NJ
Zip	:	08817-3712
Country	:	US
Telephone Number	:	347-422-7645
Fax Number	:

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

Provider Enumeration Date	:	11/02/2021
Last Update Date	:	04/10/2026

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