Provider Demographics
NPI:1992875280
Name:SZCZEPANIK, EDWIN (DMD)
Entity type:Individual
Prefix:
First Name:EDWIN
Middle Name:
Last Name:SZCZEPANIK
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 1:7758 WALLACE RD
Mailing Address - Street 2:SUITE III
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32819-7219
Mailing Address - Country:US
Mailing Address - Phone:407-352-6888
Mailing Address - Fax:407-352-0560
Practice Address - Street 1:7758 WALLACE RD
Practice Address - Street 2:SUITE III
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32819-7219
Practice Address - Country:US
Practice Address - Phone:407-352-6888
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-08
Last Update Date:2019-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN8437332B00000X, 122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies