Lumina Dental of Lakeland,PA

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

LUMINA DENTAL OF LAKELAND,PA

Doing business as

LUMINA DENTAL OF LAKELAND

Practice address

4912 Southfork Dr
Lakeland, FL 33813-2042

Phone

(863) 455-4348

NPI assigned

Dec 20, 2019

Organization subpart

No

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

Authorized official

Name

John Ivey, DMD

Title

Owner

Phone

(321) 431-2208

Specialties & licenses 1

Addresses

Other names 1

• LUMINA DENTAL OF LAKELAND Doing business as

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

{
    "created_epoch": "1576800000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1576800000000",
    "number": "1487292454",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4912 SOUTHFORK DR",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338132042",
            "telephone_number": "863-455-4348"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4912 SOUTHFORK DR",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338132042",
            "telephone_number": "863-455-4348"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LUMINA DENTAL OF LAKELAND,PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-12-20",
        "last_updated": "2019-12-20",
        "certification_date": "2019-12-20",
        "status": "A",
        "authorized_official_last_name": "IVEY",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "321-431-2208",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "LUMINA DENTAL OF LAKELAND",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jose Lugo, DO
• Luis Alberto Lugo Jr., LMT
• Luis C Favilli MD LLC
• Jeswin Lukose, RPH
• Lumikids Ppec LLC
• Fadette Lumorin, FNP-BC
• Graciela Margarita Luna, MD
• Kara Suzanne Lund, MD
• Mariela K Lung, DMD
• Yansu Luo

• Dental Clinic/Center in Lakeland, FL
• Providers in Lakeland, FL by specialty
• Dental Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2019; 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.