Healthcare Provider Details

I. General information

NPI: 1861846933
Provider Name (Legal Business Name): ANDREW LEPINE DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/14/2016
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

157 TOWNE AVE
PLAINFIELD VT
05667-9425
US

IV. Provider business mailing address

111 COLCHESTER AVE
BURLINGTON VT
05401-1473
US

V. Phone/Fax

Practice location:
  • Phone: 802-454-8336
  • Fax:
Mailing address:
  • Phone: 802-847-2700
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number016.0132151
License Number StateVT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: