Provider Demographics
NPI:1972707503
Name:SOMMER, LORI (DDS)
Entity Type:Individual
Prefix:DR
First Name:LORI
Middle Name:
Last Name:SOMMER
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9 BENDER CT
Mailing Address - Street 2:
Mailing Address - City:DIX HILLS
Mailing Address - State:NY
Mailing Address - Zip Code:11746-6100
Mailing Address - Country:US
Mailing Address - Phone:631-274-9244
Mailing Address - Fax:631-274-9243
Practice Address - Street 1:2001 MARCUS AVE
Practice Address - Street 2:SUITE W82
Practice Address - City:NEW HYDE PARK
Practice Address - State:NY
Practice Address - Zip Code:11042-1011
Practice Address - Country:US
Practice Address - Phone:516-328-1144
Practice Address - Fax:516-328-1147
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY388111223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice