Dr Lisa Ann Jedacek, DMD, MPH - Dentist in Bronx, NY

Dr Lisa Ann Jedacek, DMD, MPH is a Dentist - Dentist Anesthesiologist based in Bronx, New York. Dr Lisa Ann Jedacek is licensed to practice in Virginia (license number 0401418721) and her current practice location is 1400 Pelham Pkwy S, Bronx, New York. She can be reached at her office (for appointments etc.) via phone at (718) 918-5000.

NPI number for Dr Lisa Ann Jedacek is 1528650710 and her current mailing address is 1817 Mayflower Ave, Bronx, New York. She does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1528650710.

Contact Information

Dr Lisa Ann Jedacek, DMD, MPH
1400 Pelham Pkwy S,
Bronx, NY 10461-1197
(718) 918-5000
Not Available

Map and Direction




Healthcare Provider's Profile

Full NameDr Lisa Ann Jedacek
GenderFemale
SpecialityDentist - Dentist Anesthesiologist
Location1400 Pelham Pkwy S, Bronx, New York
Accepts Medicare AssignmentsDoes not participate in Medicare Program. She may not accept medicare assignment.
  NPI Data:
  • NPI Number: 1528650710
  • Provider Enumeration Date: 02/09/2021
  • Last Update Date: 07/09/2024

Medical Identifiers

Medical identifiers for Dr Lisa Ann Jedacek such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1528650710NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
122300000XDentist 22DI03015700 (New Jersey)Secondary
122300000XDentist 0401418721 (Virginia)Secondary
1223D0004XDentist - Dentist Anesthesiologist DN10000315 (Massachusetts)Secondary
1223D0004XDentist - Dentist Anesthesiologist 2901602093 (Michigan)Secondary
122300000XDentist DN10000315 (Massachusetts)Secondary
122300000XDentist 2901602093 (Michigan)Secondary
122300000XDentist 30.027607 (Ohio)Secondary
1223D0004XDentist - Dentist Anesthesiologist 30.027607 (Ohio)Secondary
1223D0004XDentist - Dentist Anesthesiologist 0401418721 (Virginia)Primary

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Lisa Ann Jedacek is NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Dr Lisa Ann Jedacek, DMD, MPH
1817 Mayflower Ave,
Bronx, NY 10461-4103

Ph: (440) 665-3973
Dr Lisa Ann Jedacek, DMD, MPH
1400 Pelham Pkwy S,
Bronx, NY 10461-1197

Ph: (718) 918-5000

Reviews and Comments


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