Provider Demographics
NPI:1154076339
Name:LEMIRE DENTAL CORPORATION
Entity Type:Organization
Organization Name:LEMIRE DENTAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:KIM
Authorized Official - Middle Name:
Authorized Official - Last Name:LEMIRE
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:147-380-4202
Mailing Address - Street 1:810 KNOB HILL AVE
Mailing Address - Street 2:
Mailing Address - City:REDONDO BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90277-4347
Mailing Address - Country:US
Mailing Address - Phone:214-738-0420
Mailing Address - Fax:
Practice Address - Street 1:14650 AVIATION BLVD STE 185
Practice Address - Street 2:
Practice Address - City:HAWTHORNE
Practice Address - State:CA
Practice Address - Zip Code:90250-6665
Practice Address - Country:US
Practice Address - Phone:310-643-9711
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-16
Last Update Date:2022-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty