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MICHAEL LYSONSKI DDS LLC
NPI 1427513902
Dentist - General Practice in Edgewood, NM

Active since February 08, 2019
1917 OLD US 66, SUITE B-C-D1, EDGEWOOD, NM 87015(262) 391-6179 Get Directions Write a Review

NPPES record last updated: March 7, 2023. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Mar 7, 2023, Feb 8, 2019 (2 updates tracked since 2019).

About Michael Lysonski Dds Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MICHAEL LYSONSKI DDS LLC (NPI 1427513902), doing business as Edgewood Dental, is a healthcare organization registered as a general practice in Edgewood, New Mexico and active in the NPI registry since February 2019. The organization lists Michael Lysonski, Dr., as its authorized official.

NPPES Registry Identity

NPI1427513902
Entity TypeOrganization
Primary Taxonomy1223G0001X
Legal Business NameMICHAEL LYSONSKI DDS LLC
Location Address1917 OLD US 66, SUITE B-C-D1Edgewood, NM 87015-6799
Mailing Address1520 La Tuna Pl SeAlbuquerque, NM 87123-4412 · (262) 391-6179
Phone(262) 391-6179
Organization SubpartNo
Authorized OfficialMichael LysonskiDr. · (262) 391-6179
Enumeration DateFebruary 8, 2019
Last NPPES UpdateMarch 7, 20232 updates tracked since enumeration
✔ NPI 1427513902 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · General PracticeDental Providers
Taxonomy Code1223G0001X
Definition
A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.
1917 OLD US 66, Edgewood, NM 87015
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Other Names 1

Doing Business AsEdgewood Dental

Other Identifiers 4

Medicaid17933030NM
OtherDD4113NM · Nm Dental License
Other03-426588-00-0NM · Nmcrs
OtherCS00220539NM · Nm Controlled Substance

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

ELIZABETH C CHRISTENSEN LMT
Massage Therapist
1917 OLD US 66, SUITE G
EDGEWOOD, NM 87015
Santa Fe County (505) 980-3599

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Michael Lysonski Dds LLC's NPI number?

The NPI number for Michael Lysonski Dds LLC is 1427513902. It was assigned to this organization in the NPPES registry on February 8, 2019. The provider is doing business as Edgewood Dental.

Where is Michael Lysonski Dds LLC located?

Michael Lysonski Dds LLC is located at 1917 Old Us 66 Suite B-C-D1, Edgewood, NM 87015. The listed phone number is (262) 391-6179.

What is Michael Lysonski Dds LLC's specialty?

The primary specialty registered for this NPI is Dentist, specializing in General Practice, with taxonomy code 1223G0001X.

When was this NPI record last updated?

The NPPES record for Michael Lysonski Dds LLC was last updated on March 7, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.