Provider Demographics
NPI:1063425148
Name:LEPORE, LYNDA M (DDS)
Entity type:Individual
Prefix:DR
First Name:LYNDA
Middle Name:M
Last Name:LEPORE
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 1:724 CLOVERLY ST
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20905-4161
Mailing Address - Country:US
Mailing Address - Phone:301-384-6000
Mailing Address - Fax:301-384-7421
Practice Address - Street 1:724 CLOVERLY ST
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20905-4161
Practice Address - Country:US
Practice Address - Phone:301-384-6000
Practice Address - Fax:301-384-7421
Is Sole Proprietor?:No
Enumeration Date:2006-08-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD83501223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice