Provider Demographics
NPI:1912423377
Name:STREETS, LEJLA (DMD)
Entity type:Individual
Prefix:DR
First Name:LEJLA
Middle Name:
Last Name:STREETS
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 VILLIAGE CLUB CT STE 200
Mailing Address - Street 2:
Mailing Address - City:PINEHURST
Mailing Address - State:NC
Mailing Address - Zip Code:28374-8554
Mailing Address - Country:US
Mailing Address - Phone:910-240-2922
Mailing Address - Fax:
Practice Address - Street 1:7 VILLIAGE CLUB CT STE 200
Practice Address - Street 2:
Practice Address - City:PINEHURST
Practice Address - State:NC
Practice Address - Zip Code:28374-8554
Practice Address - Country:US
Practice Address - Phone:910-240-2922
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-08-17
Last Update Date:2024-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC115711223G0001X, 122300000X, 1223S0112X
TX333001223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery
No1223G0001XDental ProvidersDentistGeneral Practice
Yes122300000XDental ProvidersDentist