Lisa M Ma, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DN 21326 Issued in FL

Practice address

5347 N Socrum Loop Rd
Lakeland, FL 33809-4256

Phone

(863) 606-5721

NPI assigned

Jul 6, 2015

Last updated

Aug 17, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Networks

• Freedom Health HMO Network

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Lisa M Ma DMD, PLLC

  • Dental Clinic/Center
  • Lakeland, FL
  • NPI 1952928251
  NPD Authorized official
• Coast Dental P.a.

  dba Coast Dental-North Lakeland

  • Dentist
  • Lakeland, FL
  • NPI 1265008502
  NPD (past)
• Coast Dental P.a.

  • Dentist
  • Tampa, FL
  • NPI 1992803860
  NPD (past)

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

{
    "created_epoch": "1436140800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629158400000",
    "number": "1649653957",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5347 N SOCRUM LOOP RD",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338094256",
            "telephone_number": "863-606-5721"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5347 N SOCRUM LOOP RD",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338094256",
            "telephone_number": "863-606-5721"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MA",
        "first_name": "LISA",
        "middle_name": "M",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-07-06",
        "last_updated": "2021-08-17",
        "certification_date": "2021-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN 21326",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• LWRC Inc (Lake Wire Retirement Center)
• Katie Reisman Lynch, PA-C
• Ramona Lyon, APRN
• Jessica Lyons, PA-C
• M & M Transport Care
• Raissa Prisca Mabaya, FNP-BC
• Makenzie Gordon Mabe, PA-C
• Mary Mabry, DMD
• Lance Macblane
• Alyssa L Macca, APRN

• 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 Aug 17, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.