Provider Demographics
NPI:1992974133
Name:MICHAEL LIPSON DDS INC
Entity type:Organization
Organization Name:MICHAEL LIPSON DDS INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:LIPSON
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:513-563-6611
Mailing Address - Street 1:11438 LEBONON ROAD SUITE C
Mailing Address - Street 2:
Mailing Address - City:SHARONVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:45241
Mailing Address - Country:US
Mailing Address - Phone:513-563-6611
Mailing Address - Fax:513-563-4107
Practice Address - Street 1:11438 LEBONON ROAD SUITE C
Practice Address - Street 2:
Practice Address - City:SHARONVILLE
Practice Address - State:OH
Practice Address - Zip Code:45241
Practice Address - Country:US
Practice Address - Phone:513-563-6611
Practice Address - Fax:513-563-4107
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-21
Last Update Date:2008-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH150341223P0300X
FL60491223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0300XDental ProvidersDentistPeriodonticsGroup - Multi-Specialty