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

Main Street Childrens Dentistry and Orthodontics of Lakewood Ranch Pll

Organization Orthodontics and Dentofacial Orthopedics Dentistry · NPI 1790273159

Main Street Childrens Dentistry and Orthodontics of Lakewood Ranch Pll is an Orthodontics and Dentofacial Orthopedics Dentistry in Bradenton, Florida. Registered with an NPI since 2018.

In the registry since
2018

Practice location Address checks out

11649 Sr 70 E Ste 109
Bradenton, FL 34202
Phone: (941) 209-1213
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Orthodontics and Dentofacial Orthopedics Dentistry (primary) Taxonomy 1223X0400X

Record details

NPI number1790273159
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Stephanie Gomez — Credentialing Supervisor · (305) 274-2499
NPI enumeratedMay 1, 2018
Last updated in NPPESMay 1, 2018
Mailing address6240 Lake Osprey Dr Dept 50226, Lakewood Ranch, FL 34240-8421

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