Cheryl Lynn Pisano, DMD
Individual provider Active NPI Dentist · Lady Lake, FL
NPI 1154630341 · NPPES record last updated Jun 12, 2024
Key facts
- NPI
- 1154630341
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dentist 122300000X
- License
- DN17274 (FL)
- Practice address
- 8575 NE 138TH LN Ste 105
Lady Lake, FL 32159-8996 - Phone
- (352) 364-0064
- Fax
- (352) 364-0065
- NPI assigned
- Oct 5, 2010
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
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 |
|---|---|---|---|
| DN17274 | FL | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Cnjuenger | Past |
Accepting new patients | |
| Dunnellon Dentistry | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | DN17274 | FL | Yes |
Addresses
Primary practice location
8575 NE 138TH LN Ste 105
Lady Lake, FL 32159-8996
Mailing address
8575 NE 138TH LN Ste 105
Lady Lake, FL 32159-8996
Phone (352) 364-0064
Other providers in Lady Lake, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 12, 2024. 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.