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General NPI Number Information
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NPI Number | 1013198878
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Entity Type | Individual
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Provider Name | MIGUEL LEWIS DEFINA D.D.S., M.S.D.
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Gender | Male
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Dates
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Enumeration Date | 11/21/2007
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Last Update Date | 08/29/2025
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Provider Practice Location Address
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Address Line | 5005 STATE RD
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City | ASHTABULA
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State | OH
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Zip | 44004-6265
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Country | US
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Telephone | 440-992-3146
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Fax | 440-998-6932
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Provider Business Mailing Address
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Address Line | 29001 CEDAR RD SUITE 450
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City | LYNDHURST
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State | OH
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Zip | 44124-4062
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Country | US
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Telephone | 440-461-3400
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Fax | 440-461-1722
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0300X
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Taxonomy Name | Periodontics
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License Number | 30022088
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License Number State | OH
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