Provider Demographics
NPI:1043369309
Name:LAKE EMMA DENTAL L.L.C
Entity Type:Organization
Organization Name:LAKE EMMA DENTAL L.L.C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ASHIFA
Authorized Official - Middle Name:
Authorized Official - Last Name:PARPIA
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:407-804-9977
Mailing Address - Street 1:3809 LAKE EMMA RD
Mailing Address - Street 2:
Mailing Address - City:LAKE MARY
Mailing Address - State:FL
Mailing Address - Zip Code:32746-3399
Mailing Address - Country:US
Mailing Address - Phone:407-804-9977
Mailing Address - Fax:
Practice Address - Street 1:3809 LAKE EMMA RD
Practice Address - Street 2:
Practice Address - City:LAKE MARY
Practice Address - State:FL
Practice Address - Zip Code:32746-3399
Practice Address - Country:US
Practice Address - Phone:407-804-9977
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN147721223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty