Provider Demographics
NPI:1669950192
Name:WILKINS, LORENA NORA (DDS)
Entity type:Individual
Prefix:
First Name:LORENA
Middle Name:NORA
Last Name:WILKINS
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 1:7500 LAKE ANDREW DR UNIT 102103
Mailing Address - Street 2:
Mailing Address - City:MELBOURNE
Mailing Address - State:FL
Mailing Address - Zip Code:32940-8762
Mailing Address - Country:US
Mailing Address - Phone:321-622-3033
Mailing Address - Fax:
Practice Address - Street 1:7500 LAKE ANDREW DR UNIT 102103
Practice Address - Street 2:
Practice Address - City:MELBOURNE
Practice Address - State:FL
Practice Address - Zip Code:32940-8762
Practice Address - Country:US
Practice Address - Phone:321-622-3033
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-06
Last Update Date:2024-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN237641223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice