Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Jordan Lissauer, DMD

Individual provider Orthodontics and Dentofacial Orthopedics Dentistry · NPI 1730467564

Jordan Lissauer, DMD is an Orthodontics and Dentofacial Orthopedics Dentistry in Staten Island, New York. Works from 2 locations. Licensed in New York.

Licensed in
NY
In the registry since
2011
What do these letters mean?
DMD — Doctor of Dental Medicine
A dentist. Identical training and licensing to a DDS.

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Practice location Address checks out

3767 Hylan Blvd
Staten Island, NY 10308-3505
Phone: (718) 966-2720
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 129 Slosson Ave, Staten Island, NY 10314-2522 — (718) 966-2720

Specialties & licences

Orthodontics and Dentofacial Orthopedics Dentistry (primary) Taxonomy 1223X0400X · Licence 055112 (NY)

Record details

NPI number1730467564
Entity typeIndividual (Type 1)
GenderMale
Credentials DMD
Sole proprietorNo
NPI enumeratedJuly 27, 2011
Last updated in NPPESAugust 3, 2026
Certification dateAugust 3, 2026

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