Lake Ridge Endodontics in Lake Ridge - Endodontics
Lake Ridge Endodontics - NPI 1205933405
Lake Ridge Endodontics is a Endodontics in Lake Ridge, Virginia. Lake Ridge Endodontics practices all healthcare services and medical treatments related to Endodontics. The NPI Number for Lake Ridge Endodontics is 1205933405. The last update date is 2008-07-09.
Lake Ridge Endodontics's current location address is 12510 Lake Ridge Dr Ste C, Lake Ridge, Virginia. You can contact this provider via phone number 7034948624 and fax number 7034971258. The mailing address for Lake Ridge Endodontics is 12510 Lake Ridge Dr Ste C, Lake Ridge, Virginia. To know further, please read the information below!
Provider Profile Detail
| Provider Organization | Lake Ridge Endodontics |
|---|---|
| Address | 12510 Lake Ridge Dr Ste C, Lake Ridge, Virginia |
| Phone Number | 7034948624 |
| Fax Number | 7034971258 |
| Sole Proprietor | -- |
| Credentials | -- |
Authorized Official
| Title or Position | OWNER/ENDO |
|---|---|
| Authorized Official Name | Wynkoop E Todd |
| Credentials | DDS MS |
| Telephone Number | 7034948624 |
NPI Number Detail
| NPI Number | 1205933405 |
|---|---|
| Provider Enumeration Date | 2006-09-20 |
| Last Updated Date | 2008-07-09 |
Provider Mailing Address Detail
| Address | 12510 Lake Ridge Dr Ste C |
|---|---|
| City | Lake Ridge |
| State | Virginia (VA) |
| Post Code | 221927501 |
| Phone Number | 7034948624 |
| Fax Number | 7034971258 |
Provider's Primary Taxonomy Detail
| Speciality | Endodontics |
|---|---|
| Taxonomy | 1223E0200X |
| Licence No | 41007464 |
|
Definition: The branch of dentistry that is concerned with the morphology, physiology and pathology of the human dental pulp and periradicular tissues. Its study and practice encompass the basic and clinical sciences including biology of the normal pulp, the eti |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 872859 | UNITED CONCORDIA | ||
| 174982 | BLUE CROSS BLUE SHIELD |
Post Comment/ Review Below
What is the Lake Ridge Endodontics's 1205933405?
The Lake Ridge Endodontics's NPI (National Provider Identifier) Number is 1205933405. This unique 10-digit identification number is assigned to health care providers by the Centers for Medicare & Medicaid Services (CMS).
Could you provide the complete address where Lake Ridge Endodontics is physically located?
The Lake Ridge Endodontics is situated at the following address: 12510 Lake Ridge Dr Ste C, Lake Ridge, VA 221927501.
What is the area of specialization for Lake Ridge Endodontics, and what is the corresponding taxonomy classification code for this field?
The specialized field of practice for Lake Ridge Endodontics is Endodontics, and the corresponding taxonomy code that categorizes this area of expertise is 1223E0200X.
When did the Lake Ridge Endodontics receive its 1205933405?
The Lake Ridge Endodontics was issued its 1205933405 on 2006-09-20, which is the date when the organization was assigned this unique identifier.
As of what date were the details pertaining to Lake Ridge Endodontics last refreshed?
The information related to the Lake Ridge Endodontics, including its address, specialty, and other relevant details, was last updated on 2008-07-09.