Provider Demographics
NPI:1669640033
Name:DAVID L. SIPES, DDS, INC., PC
Entity Type:Organization
Organization Name:DAVID L. SIPES, DDS, INC., PC
Other - Org Name:DAVID L SIPES & ASSOCIATES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:L
Authorized Official - Last Name:SIPES
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:419-884-3411
Mailing Address - Street 1:26 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:OH
Mailing Address - Zip Code:44904-1223
Mailing Address - Country:US
Mailing Address - Phone:419-884-3411
Mailing Address - Fax:419-884-0656
Practice Address - Street 1:26 E MAIN ST
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:OH
Practice Address - Zip Code:44904-1223
Practice Address - Country:US
Practice Address - Phone:419-884-3411
Practice Address - Fax:419-884-0656
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-19
Last Update Date:2008-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH30015212122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty