Provider Demographics
NPI:1750547659
Name:LEXINGTON DENTAL GROUP
Entity type:Organization
Organization Name:LEXINGTON DENTAL GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ALAN
Authorized Official - Middle Name:
Authorized Official - Last Name:SLUTSKY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-679-9340
Mailing Address - Street 1:11767 KATY FWY STE 505
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77079-1768
Mailing Address - Country:US
Mailing Address - Phone:281-679-9340
Mailing Address - Fax:281-679-9380
Practice Address - Street 1:11767 KATY FWY STE 505
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77079-1768
Practice Address - Country:US
Practice Address - Phone:281-679-9340
Practice Address - Fax:281-679-9380
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-31
Last Update Date:2008-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
No305R00000XManaged Care OrganizationsPreferred Provider OrganizationGroup - Single Specialty