Provider Demographics
NPI:1821264409
Name:ORLANDO ENDODONTIC SPECIALISTS, P.A.
Entity Type:Organization
Organization Name:ORLANDO ENDODONTIC SPECIALISTS, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS MGR
Authorized Official - Prefix:
Authorized Official - First Name:LAUREN
Authorized Official - Middle Name:
Authorized Official - Last Name:LIPKIN
Authorized Official - Suffix:
Authorized Official - Credentials:JD
Authorized Official - Phone:407-423-7667
Mailing Address - Street 1:610 N MILLS AVE
Mailing Address - Street 2:STE 210
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32803-7119
Mailing Address - Country:US
Mailing Address - Phone:407-423-7667
Mailing Address - Fax:
Practice Address - Street 1:610 N MILLS AVE
Practice Address - Street 2:STE 210
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32803-7119
Practice Address - Country:US
Practice Address - Phone:407-423-7667
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-05
Last Update Date:2008-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN 143841223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223E0200XDental ProvidersDentistEndodonticsGroup - Single Specialty