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General NPI Number Information
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NPI Number | 1720238272
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Entity Type | Individual
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Provider Name | SHIRA LEAH LIPPMAN DDS
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Gender | Female
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Dates
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Enumeration Date | 09/22/2008
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Last Update Date | 09/22/2008
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Provider Practice Location Address
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Address Line | 189 WHEATLEY RD
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City | GLEN HEAD
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State | NY
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Zip | 11545-2641
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Country | US
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Telephone | 516-686-4400
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Fax |
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Provider Business Mailing Address
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Address Line | 1 BUNGTOWN RD
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City | COLD SPRING HARBOR
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State | NY
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Zip | 11724-2209
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Country | US
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Telephone | 516-208-2427
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Fax |
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | 051449
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License Number State | NY
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