Mindy Michelle Lombere
Individual provider Active NPI Dentist · Lakeland, GA
NPI 1144918608 · NPPES record last updated Jan 9, 2025
Key facts
- NPI
- 1144918608
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dentist 122300000X
- License
- DN123100 (GA)
- Practice address
- 33 Hospital Dr
Lakeland, GA 31635-5716 - Phone
- (229) 482-1100
- Fax
- (229) 482-1103
- NPI assigned
- Apr 24, 2023
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DN123100 | GA | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lakeland Family Dentistry | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Dentist | 122300000X | DN123100 | GA | Yes |
Addresses
Primary practice location
33 Hospital Dr
Lakeland, GA 31635-5716
Mailing address
30688 Bloomsbury LN
Cathedral City, CA 92234-2581
Phone (760) 855-5992
Other practice location 1
30688 Bloomsbury Ln
Cathedral City, CA 92234-2581
Phone (760) 855-5992
Other providers in Lakeland, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 9, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.