Healthcare Provider Details

I. General information

NPI: 1033021456
Provider Name (Legal Business Name): ELIZABETH LAPENNA, DMD, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/21/2026
Last Update Date: 09/21/2026
Certification Date: 08/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3719 PROVIDENCE RD S
WAXHAW NC
28173
US

IV. Provider business mailing address

3919 PROVIDENCE RD S, STE B PO BOX 241
WAXHAW NC
28173-6996
US

V. Phone/Fax

Practice location:
  • Phone: 704-774-5064
  • Fax:
Mailing address:
  • Phone: 704-774-5064
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number State

VIII. Authorized Official

Name: DR. ELIZABETH ALLISON LAPENNA
Title or Position: DENTIST/OWNER
Credential: DMD
Phone: 704-774-5064