Organization
MAIN STREET CHILDRENS DENTISTRY AND ORTHODONTICS OF LAKEWOOD RANCH PLL
Active
Organization
MAIN STREET CHILDRENS DENTISTRY AND ORTHODONTICS OF LAKEWOOD RANCH PLL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STEPHANIE GOMEZ (CREDENTIALING SUPERVISOR)
(305) 274-2499
Entity
Organization
Contact information
Practice address
11649 SR 70 EAST, SUITE 109, BRADENTON, FL 34202
(941) 209-1213
Mailing address
6240 LAKE OSPREY DR DEPT 50226, LAKEWOOD RANCH, FL 34240-8421
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
—
—
Other
Enumeration date
05/01/2018
Last updated
05/01/2018
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up