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DR. LISA ANN JEDACEK DMD, MPH
NPI 1528650710
Dentist - Dentist Anesthesiologist in Bronx, NY

Active since February 09, 2021
1400 PELHAM PKWY S, BRONX, NY 10461(718) 918-5000 Get Directions Write a Review

NPPES record last updated: July 9, 2024. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jul 9, 2024, Apr 29, 2024, Feb 9, 2021 (3 updates tracked since 2021).

About Dr. Lisa Ann Jedacek Dmd, Mph NPPES

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

DR. LISA ANN JEDACEK DMD, MPH (NPI 1528650710) is an individual dentist anesthesiologist in Bronx, New York, licensed in Virginia (0401418721) and active in the NPI registry since February 2021. She maintains 8 additional practice locations.

NPPES Registry Identity

NPI1528650710
Entity TypeIndividualFemale
Primary Taxonomy1223D0004X
Provider Legal NameDR. LISA ANN JEDACEKCredential: DMD, MPH
Location Address1400 PELHAM PKWY SBronx, NY 10461-1197
Mailing Address1817 Mayflower AveBronx, NY 10461-4103 · (440) 665-3973
Phone(718) 918-5000
Sole ProprietorNo
Enumeration DateFebruary 9, 2021
Last NPPES UpdateJuly 9, 20243 updates tracked since enumeration
NPPES CertifiedJuly 9, 2024
✔ NPI 1528650710 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyDentist · Dentist AnesthesiologistDental Providers
Taxonomy Code1223D0004X
Licenses✔ Licensed in VA · 0401418721✔ Licensed in MA · DN10000315✔ Licensed in MI · 2901602093✔ Licensed in OH · 30.027607
Definition
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.
Also ListedDentistTaxonomy 122300000X · License 22DI03015700 (NJ), 0401418721 (VA), DN10000315 (MA), 2901602093 (MI), 30.027607 (OH)
1400 PELHAM PKWY S, Bronx, NY 10461
Open in Google Maps ↗

Secondary Practice Locations 8

Location 11516 NJ-138, Suite #1aWall Township, NJ 07719 · Phone (732) 681-5544
Location 21700 Monroe StEndicott, NY 13760-5512 · Phone (607) 953-4445
Location 3378 Atlantic AveBrooklyn, NY 11217-5000 · Phone (718) 412-5221
Location 45002 Airport Rd NW # 30Roanoke, VA 24012-1607 · Phone (540) 900-4782
Location 51817 Mayflower AveBronx, NY 10461-4103 · Phone (440) 665-3973
Location 64749 S Baldwin RdLake Orion, MI 48359-2114 · Phone (248) 422-0555
Location 72165 Cunningham DrHampton, VA 23666-2569 · Phone (757) 755-8846
Location 811934 W Broad St Ste 120Henrico, VA 23233-1100 · Phone (804) 293-2662

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Delta Dental of Ohio.Insurance ›

Other Providers at the Same Location NPPES 20

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

CAROLYN COLE
Student in an Organized Health Care Education/Training Program
1400 PELHAM PKWY S
BRONX, NY 10461
Bronx County (718) 918-5820
RYAN JOHNY PHARM. D
Pharmacist
1400 PELHAM PKWY S
BRONX, NY 10461
Bronx County (718) 918-4557
DR. SARAH G JAMISON MD
Emergency Medicine
1400 PELHAM PKWY S, BUILDING 6, SUITE B125
BRONX, NY 10461
Bronx County (718) 918-5820
SWETHA PEDAVALLY M.D
Psychiatry & Neurology (Clinical Neurophysiology)
1400 PELHAM PKWY S, BUILDING #1, 3N1
BRONX, NY 10461
Bronx County (718) 918-7460
MS. ODESSA FYNN CM
Midwife
1400 PELHAM PKWY S, BS. 33
BRONX, NY 10461
Bronx County (718) 918-3060
DR. PATRICK SPENCER EIBEN M.D.
Emergency Medicine
1400 PELHAM PKWY S, BUILDING 6//SUITE B125
BRONX, NY 10461
Bronx County (718) 918-5820
DR. ADAM JOSEPH GERSHON MD
Student in an Organized Health Care Education/Training Program
1400 PELHAM PKWY S
BRONX, NY 10461
Bronx County (718) 918-5000
EDIRICARDO RODRIGUEZ ORTIZ MD
Anesthesiology
1400 PELHAM PKWY S
BRONX, NY 10461
Bronx County (718) 918-5000

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 Lisa Jedacek's NPI number?

The NPI number for Lisa Jedacek is 1528650710. It was assigned to this individual provider in the NPPES registry on February 9, 2021.

Where is Lisa Jedacek located?

Lisa Jedacek practices at 1400 Pelham Pkwy S, Bronx, NY 10461. The listed phone number is (718) 918-5000.

What is Lisa Jedacek's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Dentist Anesthesiologist, with taxonomy code 1223D0004X.

What insurance does Lisa Jedacek accept?

Health plans from Delta Dental of Ohio list Lisa Jedacek as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Lisa Jedacek was last updated on July 9, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.