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 provides Dentist services 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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