Individual Healthcare Provider
Lisa Ann Jedacek, DMD, MPH
Provider's NPPES record last updated: July 9, 2024
Overview
- Entity Type
- Individual Healthcare Provider
- NPI
- 1528650710
- Primary Specialty
- Dentist — Dental Anesthesiology
- Practice Location
- Bronx, New York
- Sole Proprietor
- No
Federal Screening
NPISignal checked this NPI against federal exclusion sources. Results below are based on the NPI number itself — an identifier match, not a name match.
List of Excluded Individuals/Entities (LEIE)
HHS Office of Inspector General
No potential match was identified in NPISignal's indexed List of Excluded Individuals/Entities (LEIE) records as of 2026-09-10.
- Source data
- September 10, 2026
- Records indexed
- 84,001
- Screened
- Sep 18, 2026, 8:51 AM UTC
This reflects only the records NPISignal currently holds and the identity information supplied. It is not a verification of eligibility, licensure, or compliance. Verify decisions that matter against the authoritative source.
SAM.gov Exclusions
U.S. General Services Administration
SAM.gov Exclusions was not checked.
SAM.gov screening is not configured on this deployment. No SAM check has been performed.
- Screened
- Not checked
This is an NPI-based check only. NPISignal does not publish name-based exclusion matches on a provider profile. A shared or similar name is a lead that requires human review, not an identification, and this page is not the place to make one. Run a name-based screening below to see potential matches with the reasons for each.
This reflects only the records NPISignal currently holds and the identity information supplied. It is not a verification of eligibility, licensure, or compliance. Verify decisions that matter against the authoritative source.
Searches OIG LEIE and SAM.gov by name and reviews every potential match.
Specialties & Taxonomies
- Primary
Dentist
Dental Anesthesiology
Dental Providers
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.
Taxonomy code 1223D0004X Dentist
Dental Providers
A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist.
Taxonomy code 122300000X
Provider-Reported License Information
- Dentist (Virginia)
- 0401418721
- Dentist (New Jersey)
- 22DI03015700
- Dentist (Virginia)
- 0401418721
- Dentist (Massachusetts)
- DN10000315
- Dentist (Michigan)
- 2901602093
- Dentist (Massachusetts)
- DN10000315
- Dentist (Michigan)
- 2901602093
- Dentist (Ohio)
- 30.027607
- Dentist (Ohio)
- 30.027607
Practice Locations
Practice Location
1400 Pelham Pkwy S
Bronx, New York 10461-1197
Phone: (718) 918-5000
Additional Practice Location
1516 Nj-138
Suite #1a
Wall Township, New Jersey 07719
Phone: (732) 681-5544
Additional Practice Location
1700 Monroe St
Endicott, New York 13760-5512
Phone: (607) 953-4445
Additional Practice Location
378 Atlantic Ave
Brooklyn, New York 11217-5000
Phone: (718) 412-5221
Additional Practice Location
378 Atlantic Ave
Brooklyn, New York 11217-5000
Phone: (718) 412-5221
Additional Practice Location
5002 Airport Rd Nw # 30
Roanoke, Virginia 24012-1607
Phone: (540) 900-4782
Additional Practice Location
1817 Mayflower Ave
Bronx, New York 10461-4103
Phone: (440) 665-3973
Additional Practice Location
4749 S Baldwin Rd
Lake Orion, Michigan 48359-2114
Phone: (248) 422-0555
Additional Practice Location
2165 Cunningham Dr
Hampton, Virginia 23666-2569
Phone: (757) 755-8846
Additional Practice Location
11934 W Broad St Ste 120
Henrico, Virginia 23233-1100
Phone: (804) 293-2662
Record Information
- Enumeration Date
- February 9, 2021
- Provider's NPPES Record Last Updated
- July 9, 2024
- Certification Date
- July 9, 2024
- NPISignal NPPES Dataset
- August 2026
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