Provider Demographics
NPI:1013275460
Name:LIPMAN, IVEY LEIGH (DMD)
Entity Type:Individual
Prefix:DR
First Name:IVEY
Middle Name:LEIGH
Last Name:LIPMAN
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 W 45TH ST
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10036-4905
Mailing Address - Country:US
Mailing Address - Phone:212-382-3782
Mailing Address - Fax:
Practice Address - Street 1:7 W 45TH ST
Practice Address - Street 2:2ND FLOOR
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10036-4905
Practice Address - Country:US
Practice Address - Phone:212-382-3782
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-04-23
Last Update Date:2017-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY056961122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist