Provider Demographics
NPI:1487796686
Name:LIPTON, JEFFREY I (DMD)
Entity type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:I
Last Name:LIPTON
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30700 TELEGRAPH RD
Mailing Address - Street 2:SUITE 2676
Mailing Address - City:BINGHAM FARMS
Mailing Address - State:MI
Mailing Address - Zip Code:48025
Mailing Address - Country:US
Mailing Address - Phone:248-645-6363
Mailing Address - Fax:248-645-6389
Practice Address - Street 1:30700 TELEGRAPH RD
Practice Address - Street 2:SUITE 2676
Practice Address - City:BINGHAM FARMS
Practice Address - State:MI
Practice Address - Zip Code:48025
Practice Address - Country:US
Practice Address - Phone:248-645-6363
Practice Address - Fax:248-645-6389
Is Sole Proprietor?:No
Enumeration Date:2007-02-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI98991223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice