Provider Demographics
NPI:1417202532
Name:LEXINGTON ENDODONTICS
Entity Type:Organization
Organization Name:LEXINGTON ENDODONTICS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:RAMZI
Authorized Official - Middle Name:
Authorized Official - Last Name:SARKIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:781-325-8181
Mailing Address - Street 1:446 WALNUT ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLINE
Mailing Address - State:MA
Mailing Address - Zip Code:02445-5918
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:922 WALTHAM ST
Practice Address - Street 2:SUITE 204
Practice Address - City:LEXINGTON
Practice Address - State:MA
Practice Address - Zip Code:02421-8019
Practice Address - Country:US
Practice Address - Phone:781-325-8181
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-07-14
Last Update Date:2012-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MADN20630261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental