Provider Demographics
NPI:1245402023
Name:JAMES J. LIPAJ AND ASSOCIATES
Entity Type:Organization
Organization Name:JAMES J. LIPAJ AND ASSOCIATES
Other - Org Name:JAMES J. LIPAJ D.D.S.
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:J
Authorized Official - Last Name:LIPAJ
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:330-658-4747
Mailing Address - Street 1:201 N PORTAGE ST
Mailing Address - Street 2:
Mailing Address - City:DOYLESTOWN
Mailing Address - State:OH
Mailing Address - Zip Code:44230-1353
Mailing Address - Country:US
Mailing Address - Phone:330-658-4747
Mailing Address - Fax:330-658-3785
Practice Address - Street 1:201 N PORTAGE ST
Practice Address - Street 2:
Practice Address - City:DOYLESTOWN
Practice Address - State:OH
Practice Address - Zip Code:44230-1353
Practice Address - Country:US
Practice Address - Phone:330-658-4747
Practice Address - Fax:330-658-3785
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-01
Last Update Date:2008-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0510058Medicaid