Lady Lake Dental Care, LLC

Primary specialty

DentistTaxonomy code 122300000X

License

DN13227 Issued in FL

Legal business name

LADY LAKE DENTAL CARE, LLC

Practice address

13915 N US Highway 441
Lady Lake, FL 32159-8924

Phone

(352) 753-6365

Fax

(352) 753-9865

NPI assigned

Jan 23, 2014

Last updated

Jan 23, 2014By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ms. Sonia E J

Title

MGR

Phone

(321) 945-9545

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1390435200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1390435200000",
    "number": "1376966598",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13915 N US HIGHWAY 441",
            "city": "LADY LAKE",
            "state": "FL",
            "postal_code": "321598924",
            "telephone_number": "352-753-6365",
            "fax_number": "352-753-9865"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13915 N US HIGHWAY 441",
            "city": "LADY LAKE",
            "state": "FL",
            "postal_code": "321598924",
            "telephone_number": "352-753-6365",
            "fax_number": "352-753-9865"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LADY LAKE DENTAL CARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-01-23",
        "last_updated": "2014-01-23",
        "status": "A",
        "authorized_official_last_name": "J",
        "authorized_official_first_name": "SONIA",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "MGR",
        "authorized_official_telephone_number": "321-945-9545",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "DN13227",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Dentist in Lady Lake, FL
• Providers in Lady Lake, FL by specialty
• Dentist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2014; 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.