Provider Demographics
NPI:1104081520
Name:VESPIA, LORI (DMD)
Entity type:Individual
Prefix:DR
First Name:LORI
Middle Name:
Last Name:VESPIA
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 1:13 ORCHARDVIEW DR
Mailing Address - Street 2:
Mailing Address - City:SEWELL
Mailing Address - State:NJ
Mailing Address - Zip Code:08080-3537
Mailing Address - Country:US
Mailing Address - Phone:856-340-8942
Mailing Address - Fax:
Practice Address - Street 1:238 SOLANA RD
Practice Address - Street 2:
Practice Address - City:PONTE VEDRA
Practice Address - State:FL
Practice Address - Zip Code:32082-2297
Practice Address - Country:US
Practice Address - Phone:904-280-1717
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-07-24
Last Update Date:2020-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN20010122300000X
NJDI10179091223G0001X
PADS027742L122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223G0001XDental ProvidersDentistGeneral Practice