MDM of Lakeland PA

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DN18829 Issued in FL

Legal business name

MDM OF LAKELAND PA

Practice address

2153 E County Road 540a
Lakeland, FL 33813-3794

Phone

(863) 709-1903

Fax

(863) 709-8833

NPI assigned

Jan 17, 2012

Organization subpart

No

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

Authorized official

Name

Dr. Jeffrey A Martin

Title

President

Phone

(863) 709-1903

Specialties & licenses 1

Addresses

Other names 1

• Highlands Dental Doing business as

Practitioners 2

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

• Nisrine Cabani, D.M.D

  • General Practice Dentistry
  • Lakeland, FL
  • NPI 1821202714
  NPD (past)
• Simon Firer, DDS

  • Dentist
  • Lakeland, FL
  • NPI 1497956122
  NPD (past)

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

{
    "created_epoch": "1326758400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1326758400000",
    "number": "1295006641",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "701 S HOWARD AVE STE 106-386",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336062473",
            "telephone_number": "863-709-1903"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2153 E COUNTY ROAD 540A",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338133794",
            "telephone_number": "863-709-1903",
            "fax_number": "863-709-8833"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MDM OF LAKELAND PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-01-17",
        "last_updated": "2012-01-17",
        "status": "A",
        "authorized_official_last_name": "MARTIN",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "863-709-1903",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN18829",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Highlands Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Niquia Lyndsay McWaters, NP
• MD Mobile Ultrasound LLC
• Mda Angel Care LLC
• Mda Angel'S Adult Day Care Center, Inc
• MDD Dental, Inc
• Lacey Mead, DO
• Tonia M Meadows, COTA
• Kimberly Pauley Meagher, DPT
• Kelli Rae Meaney, DNP, NP-C
• Michelle Means, LCSW

• General Practice Dentistry in Lakeland, FL
• Providers in Lakeland, FL by specialty
• General Practice Dentistry in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.