MEDICARE: OGDEN ORTHODONTICS OF LAKE COUNTY LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223X0400X	Orthodontics and Dentofacial Orthopedics Dentistry

General Provider Information

NPI Number	:	1194673616
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	OGDEN ORTHODONTICS OF LAKE COUNTY LLC

Provider Business Mailing Address
First Line	:	PO BOX 2850
Second Line	:
City	:	WINDERMERE
State	:	FL
Zip	:	34786-2850
Country	:	US
Telephone Number	:	407-909-3003
Fax Number	:	407-909-3004

Provider Business Practice Location Address
First Line	:	1805 MAGUIRE RD STE 101
Second Line	:
City	:	WINDERMERE
State	:	FL
Zip	:	34786-7924
Country	:	US
Telephone Number	:	407-909-3003
Fax Number	:	407-909-3004

Authorized Official
Title or Position	:	OWNER
Name	:	ROBERT OGDEN
Credential	:	DDS
Telephone Number	:	407-909-3003

Provider Enumeration Date	:	03/19/2026
Last Update Date	:	03/19/2026

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