Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Fl Southern Dental PPO PA

Organization Dentist · NPI 1841096799

Fl Southern Dental PPO PA is a Dentist in Lake Mary, Florida. Registered with an NPI since 2025.

In the registry since
2025
What do these letters mean?
PA — Professional association
A form of business registration, not a clinical qualification.

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Practice location Address checks out

4106 W Lake Mary Blvd Ste 230
Lake Mary, FL 32746-2403
Phone: (407) 333-0881
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Dentist (primary) Taxonomy 122300000X

Record details

NPI number1841096799
Entity typeOrganization (Type 2)
Organization subpartYes
Parent organizationFl Southern Dental PPO PA
Authorized official Erika Menjivar — Sr. Credentialing Specialist · (469) 596-6137
Other names Dental Lake Mary
NPI enumeratedFebruary 21, 2025
Last updated in NPPESFebruary 21, 2025
Certification dateFebruary 21, 2025
Mailing address5830 Granite Pkwy Ste 780, Plano, TX 75024-6775

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