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

Lake Mary Modern Dentistry, PA

Organization Dentist · NPI 1053849646

Lake Mary Modern Dentistry, PA is a Dentist in Lake Mary, Florida. Registered with an NPI since 2017.

In the registry since
2017
What do these letters mean?
PA — Professional association
A form of business registration, not a clinical qualification.

See every abbreviation used in this directory →

Practice location Address checks out

3779 Lake Emma Rd
Lake Mary, FL 32746
Phone: (407) 547-1359
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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 number1053849646
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Imran Hameedi — Dds/Owner · (407) 547-1359
Other names Lake Mary Modern Dentistry
NPI enumeratedMay 26, 2017
Last updated in NPPESApril 13, 2022
Certification dateApril 13, 2022
Mailing addressPo Box 920050, Dallas, TX 75392-0050

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