LUMINA DENTAL OF LAKELAND,PA (NPI# 1487292454) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1487292454 |
Entity Type | Organization |
Organization Name | LUMINA DENTAL OF LAKELAND,PA |
Practice Address |
4912 Southfork Dr Lakeland FL 33813-2042 |
Practice Telephone | 8634554348 |
Mailing Telephone | 8634554348 |
Enumeration Date | 2019-12-20 |
Last Update Date | 2019-12-20 |
Authorized Official Name | JOHN IVEY (OWNER) |
Authorized Official Telephone | 3214312208 |
Authorized Official Credential | DMD |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 261QD0000X |
Clinic/Center Specialization: Dental |
Ambulatory Health Care Facilities |
Other Name | Type Code |
---|---|
LUMINA DENTAL OF LAKELAND | Doing Business As Name - Organization |
Street Address |
4912 SOUTHFORK DR |
City | LAKELAND |
State | FL |
Zip Code | 33813-2042 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1295859957 | Robert Sutton | Dentist | 4912 Southfork Dr, Lakeland, FL 33813-2042 | 2007-03-19 |
1487084224 | Robert W. Sutton, D.m.d.,p.a. | Durable Medical Equipment & Medical Supplies | 4912 Southfork Dr, Lakeland, FL 33813-2042 | 2013-11-14 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1427600030 | Genesis Vieyra Lopez | Nurse Practitioner | 631 Mid Florida Drive, Lakeland, FL 33813 | 2019-07-13 |
1306323340 | Sandrene Smart | Clinic/Center | 625 Commerce Dr. (suite 103), Lakeland, FL 33813 | 2018-07-23 |
1033560586 | Charles D. Llano, D.d.s. | Dentist | 320 West Highland Drive, Lakeland, FL 33813 | 2016-06-27 |
1417317389 | Eye Specialists of Mid-florida, Pa | Ophthalmology | 2004 Cr 540 A, Lakeland, FL 33813 | 2016-03-04 |
1609234905 | Care and Life LLC | In Home Supportive Care | 6526 Fox Tree Lane, Lakeland, FL 33813 | 2016-02-02 |
1558731158 | Lori Ann Smith | Nurse Practitioner | 6030 S. Florida Ave, Suite 110, Lakeland, FL 33813 | 2015-09-25 |
1891182143 | Advanced Integrated Care Organization, LLC | Health Maintenance Organization | 5423 S. Florida Ave, Lakeland, FL 33813 | 2015-04-23 |
1902292352 | Central Health Associates | Internal Medicine | 4925 Old Rd 37, Lakeland, FL 33813 | 2015-04-13 |
1134542848 | Gledia Lovering | Dietitian, Registered | 6420 Highlands In The Woods St, Lakeland, FL 33813 | 2014-01-31 |
1134556368 | Billy Rogers | Nurse Anesthetist, Certified Registered | 4513 Orangewood Loop W., Lakeland, FL 33813 | 2013-10-02 |
Find all providers in zip 33813 |
Taxonomy Code | 261QD0000X |
Grouping | Ambulatory Health Care Facilities |
Classification | Clinic/Center |
Specialization | Dental |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1053961227 | Memphis Dentures and Implants Pllc | Clinic/Center | 8950 Us-64, Suite 108, Lakeland, TN 38002-4566 | 2019-09-18 |
1366085896 | Mdd Dental, Inc | Clinic/Center | 3207 S Florida Ave, Lakeland, FL 33803-4550 | 2019-10-28 |
1881064343 | Highland Park Dental | Clinic/Center | 4326 Highland Park Blvd, Lakeland, FL 33813-1647 | 2015-09-28 |
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1699376525 | Hoffmann Holdings Inc | Clinic/Center | 515 Semoran Blvd Ste 1000, Casselberry, FL 32707-5341 | 2020-11-06 |
1811598238 | Dental Plus Management, LLC | Clinic/Center | 16 Ne 2nd Ave, Deerfield Beach, FL 33441-3504 | 2020-11-03 |
1750981452 | Smillie Dental Pllc | Clinic/Center | 5537 S Williamson Blvd Ste 675, Port Orange, FL 32128-8314 | 2020-10-30 |
1609476027 | R & R Dentistry Pa | Clinic/Center | 6290 Linton Blvd Unit 202, Delray Beach, FL 33484-6409 | 2020-10-26 |
1295334126 | Friedman Dental Group Miami, Pllc | Clinic/Center | 1717 N Bayshore Dr Ste 219, Miami, FL 33132-1196 | 2020-10-21 |
1376142547 | Trm Global Enterprise,llc. | Clinic/Center | 145 Crawl Key Ct, Deland, FL 32720-3951 | 2020-10-20 |
1568060762 | Bawany LLC | Clinic/Center | 15130 Springview St, Tampa, FL 33624-2332 | 2020-10-12 |
1992312730 | Rocent Dental Care, Inc. | Clinic/Center | 1 Sw 129th Ave Ste 406, Pembroke Pines, FL 33027-1718 | 2020-09-25 |
1730795857 | Kind Smiles Dental Health | Clinic/Center | 11155 State Road 70 E, Lakewood Ranch, FL 34202 | 2020-09-23 |
1952916306 | Simmons Services LLC | Clinic/Center | 2500 Sw 107th Ave Ste 45, Miami, FL 33165-2492 | 2020-09-12 |
Find all providers with the same taxonomy |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.