DR. LISA ANN JEDACEK DMD MPH NPI 1528650710

NPI Information

  • NPI: 1528650710
  • Provider Name: DR. LISA ANN JEDACEK, DMD, MPH
  • Classification: Dentist - 1223D0004X
  • Specialization: Dentist Anesthesiologist
  • Entity Type: Individual
  • Address: 1400 PELHAM PKWY S
    BRONX, NY
    ZIP 10461
  • Phone: (718) 918-5000

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NPI Details

DR. Lisa Ann Jedacek, DMD, MPH is a dentist anesthesiologist dentist in Bronx, NY. The provider is a dentist who has successfully completed an accredited postdoctoral anesthesiology residency training program for dentists of two or more years duration, in accord with Commission on Dental Accreditation's Standards for Dental Anesthesiology Residency Programs, and/or meets the eligibility requirements for examination by the American Dental Board of Anesthesiology. DR. Lisa Ann Jedacek, DMD, MPH NPI is 1528650710. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

1400 PELHAM PKWY S
BRONX, NY
ZIP 10461-197
Phone: (718) 918-5000

The enumeration date for this NPI number is 2/9/2021 and was last updated on 7/9/2024.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1122300000XDentist22DI03015700NEW JERSEYNo
2122300000XDentist0401418721VIRGINIANo
31223D0004XDentistDentist AnesthesiologistDN10000315MASSACHUSETTSNo
41223D0004XDentistDentist Anesthesiologist2901602093MICHIGANNo
5122300000XDentistDN10000315MASSACHUSETTSNo
6122300000XDentist2901602093MICHIGANNo
7122300000XDentist30.027607OHIONo
81223D0004XDentistDentist Anesthesiologist30.027607OHIONo
91223D0004XDentistDentist Anesthesiologist0401418721VIRGINIAYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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