Blackmon, Lisa Denise
Blackmon, Lisa Denise is an sole proprietor health care provider with primary practice located at 3729 Lee Road Shaker Heights Dental Express, Shaker Heights OH 44120. She recently has only one registered license in Dental Providers / Dentist, which is considered as her primary health care specialty. Blackmon, Lisa Denise can be contacted via phone (216) 751-9922.Contact Information
Primary practice address
3729 Lee Road Shaker Heights Dental Express
Shaker Heights OH 44120
Phone: (216) 751-9922
Fax: (216) 752-0870
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Dental Providers / Dentist | 122300000X | 20813 | Ohio |
Profile Details
NPI number | 1235205527 |
---|---|
LBN Legal business name | Blackmon, Lisa Denise |
Credentials | Doctor of Dental Surgery (DDS) |
Entity | Individual |
Sole proprietor 1 | Yes |
Enumeration date | Nov 28th, 2006 |
Last updated | Oct 26th, 2009 - about 15 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1235205527 | NPPES |
Ohio | MEDICAID | 2066580 |
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