Lakeland Oral Surgery and Specialty Center PLLC

Primary specialty

DentistTaxonomy code 122300000X

Legal business name

LAKELAND ORAL SURGERY AND SPECIALTY CENTER PLLC

Practice address

3845 S Florida Ave
Lakeland, FL 33813-1122

Phone

(863) 226-4486

NPI assigned

Jul 25, 2022

Last updated

Jul 21, 2026By 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

Victoria Johnson

Title

Cro

Phone

(941) 444-0558

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1658707200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1784592000000",
    "number": "1538895495",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3845 S FLORIDA AVE",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338131122"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3845 S FLORIDA AVE",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338131122",
            "telephone_number": "863-226-4486"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2300 Forest Lake Dr Unit 107",
            "address_purpose": "LOCATION",
            "city": "Davenport",
            "state": "FL",
            "postal_code": "338378940",
            "country_code": "US",
            "telephone_number": "863-226-4486",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "LAKELAND ORAL SURGERY AND SPECIALTY CENTER PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-07-25",
        "last_updated": "2026-07-21",
        "certification_date": "2026-07-21",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "VICTORIA",
        "authorized_official_title_or_position": "CRO",
        "authorized_official_telephone_number": "941-444-0558"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Lakeland Periodontics, Inc
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• Lakeland Physicians Group
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• Dentist in Lakeland, FL
• Providers in Lakeland, FL by specialty
• Dentist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2026; 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.