Individual provider · Type 1 NPI

Jordan Lissauer, DMD

Orthodontics and Dentofacial Orthopedics Dentistry · Staten Island, NY

NPI number 1730467564 Active

Practice location

3767 Hylan Blvd
Staten Island, NY 10308-3505

Call (718) 966-2720 Map

Other practice locations

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

Specialties and licenses

TaxonomyCodeLicense
Orthodontics and Dentofacial Orthopedics Dentistry Primary 1223X0400X055112 (NY)

Orthodontics and Dentofacial Orthopedics Dentistry: That area of dentistry concerned with the supervision, guidance and correction of the growing or mature dentofacial structures, including those conditions that require movement of teeth or correction of malrelationships and malformations of their related structures and the adjustment of relationships between and among teeth and facial bones by the application of forces and/or the stimulation and redirection of funct…

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About NPI 1730467564

Jordan Lissauer, DMD's National Provider Identifier is 1730467564, issued on Jul 27, 2011. The primary taxonomy on file is Orthodontics and Dentofacial Orthopedics Dentistry (1223X0400X), and the practice location is in Staten Island, NY. The record was last updated on Aug 3, 2026.