Fleetwood Dental Professional Corporation

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DS036286 Issued in PA

Legal business name

FLEETWOOD DENTAL PROFESSIONAL CORPORATION

Practice address

805 N Richmond Street
Suite 102
Fleetwood, PA 19522

Phone

(610) 944-9771

Fax

(610) 944-0702

NPI assigned

Apr 28, 2008

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Michelle M Lee, DMDNPI 1235495128

Title

Owner

Phone

(610) 944-9771

Specialties & licenses 1

Addresses

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Michelle Lee, DMD

  • Dentist
  • Fleetwood, PA
  • NPI 1235495128
  NPD Authorized official
• David Rechlicz

  • General Practice Dentistry
  • Fleetwood, PA
  • NPI 1821662990
  NPD (past)
• Richard William Reddy, D.D.S.

  • General Practice Dentistry
  • Fleetwood, PA
  • NPI 1407883242
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1209340800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1575244800000",
    "number": "1104091388",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "805 N RICHMOND STREET",
            "address_2": "SUITE 102",
            "city": "FLEETWOOD",
            "state": "PA",
            "postal_code": "19522",
            "telephone_number": "610-944-9771",
            "fax_number": "610-944-0702"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "805 N RICHMOND STREET",
            "address_2": "SUITE 102",
            "city": "FLEETWOOD",
            "state": "PA",
            "postal_code": "19522",
            "telephone_number": "610-944-9771",
            "fax_number": "610-944-0702"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FLEETWOOD DENTAL PROFESSIONAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-28",
        "last_updated": "2019-12-02",
        "status": "A",
        "authorized_official_last_name": "LEE",
        "authorized_official_first_name": "MICHELLE",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "610-944-9771",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "PA",
            "license": "DS036286",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cora Rain Fernandez, LPC
• Christopher Ferraro
• Valerie Ann Finlan, MSN, NP-C
• Fleetwood Area School District
• Fleetwood Chiropractic & Wellness Center, PC
• Fleetwood Family Dental Care LLC
• Fleetwood Footcare Center, PC
• Fleetwood Vol Fire Co 1
• Ashley Vellela Flor, PSYD
• Maria Flores

• General Practice Dentistry in Fleetwood, PA
• Providers in Fleetwood, PA by specialty
• General Practice Dentistry in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.