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

Lakeland Modern Dentistry, PA

Organization Dentist · NPI 1235649518

Lakeland Modern Dentistry, PA is a Dentist in Lakeland, 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.

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Practice location Address checks out

4620 S Florida Ave Ste 120
Lakeland, FL 33813-2166
Phone: (863) 216-5765
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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 number1235649518
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Mary Mabry — Owner Doctor · (863) 216-5765
Other names Lakeland Modern Dentistry
NPI enumeratedOctober 2, 2017
Last updated in NPPESJune 15, 2022
Certification dateJune 15, 2022
Mailing addressPo Box 920050, Dallas, TX 75392-0050

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