Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1346974581 Individual Practitioner Male Practitioner

Dr. Lance E Leslie , DMD, MPH

Dentist • Chicago, IL

Professional Overview & Biography Verified Profile Summary

Dr. Lance Leslie, DMD, MPH is a registered healthcare professional specializing in Dentist in Chicago, IL. Practice services are available at 641 W 63RD ST under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

641 W 63rd St

Chicago, IL 606212032

Telephone 7733881600
Associated Practice Facility / Clinic
🏢 City Of Chicago Facility NPI 1871595256

Specialty Benchmarks & Practice Insights

Comparative analytics for Dentist in Chicago, IL

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 16.1 Yrs
State Avg: 12.1 Yrs
Regional Practice Density
1207 Specialists

Practicing in Chicago, IL (4751 Statewide)

Telehealth Adoption Rate
0.1% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

CMS Verified: 2025-02-06
Dentist Primary Specialty

NUCC Taxonomy Code: 122300000X

State License OH 30.027368

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.

Dentist

NUCC Taxonomy Code: 122300000X

State License IL 019033899

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.

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID
019033899 (IL)

Secondary Practice Locations

2249 Shenandoah Ave Unit 1fl

Saint Louis, MO 631042750

Phone: 6143235441

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

40 Associated Practitioners
Dr. Lauren Koby , PsyD

Psychologist - Clinical

NPI 1003374521

Doctor of Psychology (Psy.D.)

NPI 1013588698

Licensed Clinical Social Worker

Kiera Bryant

Nurse Practitioner - Women's Health

NPI 1033851134
NPI 1043370653

Doctor of Philosophy (Ph.D.)

Amaya Blue-Farrell

Physician Assistant

NPI 1053050542
NPI 1083260301

Doctor of Dental Medicine

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

11 Historical Events
📍
Updated Practice Location October 26, 2022

Registered at 641 W 63RD ST, CHICAGO, IL 606212032 (Tel: 7733881600)

📍
Updated Business Mailing Address October 26, 2022

Registered at 641 W 63RD ST, CHICAGO, IL 606212032 (Tel: 7733881600)

📍
Updated Practice Location September 08, 2022

Registered at 2249 SHENANDOAH AVE UNIT 1FL, SAINT LOUIS, MO 631042750 (Tel: 6143235441)

📍
Updated Business Mailing Address September 08, 2022

Registered at 2249 SHENANDOAH AVE UNIT 1FL, SAINT LOUIS, MO 631042750 (Tel: 6143235441)

👤
Provider Name / Credentials Updated September 08, 2022

Recorded as LANCE LESLIE, DMD, MPH

NPI Profile Active July 13, 2022

NPI status registered as active in NPPES database

📍
Updated Practice Location July 13, 2022

Registered at 1215 VANDALIA ST, COLLINSVILLE, IL 622344060 (Tel: 6183436015)

📍
Updated Business Mailing Address July 13, 2022

Registered at 1215 VANDALIA ST, COLLINSVILLE, IL 622344060 (Tel: 6183436015)

👤
Provider Name / Credentials Updated July 13, 2022

Recorded as LANCE LESLIE, DMD

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) July 13, 2022

Dentist (License #019033899 in IL)

🟢
Initial NPI Registration & Enumeration July 13, 2022

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1346974581
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: July 13, 2022
Last Update: February 06, 2025
Sole Proprietor: No

Mailing Address

641 W 63rd St

Chicago, IL 606212032

Phone: 7733881600

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.