Lisa M Ma DMD, PLLC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

LISA M MA DMD, PLLC

Practice address

5347 N Socrum Loop Rd
Lakeland, FL 33809-4256

Phone

(863) 606-5721

NPI assigned

Jul 2, 2020

Reactivated

Aug 17, 2021

Last updated

Aug 17, 2021By 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

Lisa M Ma, DMDNPI 1649653957

Title

Member

Phone

(305) 335-2252

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Lisa M Ma, DMD

  • General Practice Dentistry
  • Lakeland, FL
  • NPI 1649653957
  NPD Authorized official

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

{
    "created_epoch": "1593648000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1629158400000",
    "number": "1952928251",
    "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": {
        "organization_name": "LISA M MA DMD, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-07-02",
        "last_updated": "2021-08-17",
        "certification_date": "2021-08-17",
        "deactivation_date": "2020-11-24",
        "reactivation_date": "2021-08-17",
        "status": "A",
        "authorized_official_last_name": "MA",
        "authorized_official_first_name": "LISA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "305-335-2252",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer Lipkins, RMHCI
• Frank Joseph Lipovich, BS
• Benjamin Elliot Lippmann, D.O.
• Eric Lipson, MD
• Lisa Hiestand
• Monique L Lisowski, R.D., L.D.
• Little Royals Ppec, Inc
• Lives Matter Mental Health Services LLC
• Michelle Ann Lizotte, APRN
• LJ & Margarita Home Care LLC

• 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 Aug 17, 2021; 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.