MEDICARE: DR. ILYA LAPIN D.D.S.

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	1223G0001X	General Practice Dentistry	DN22275	FL

General Provider Information

NPI Number	:	1437508082
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ILYA LAPIN D.D.S.

Provider Business Mailing Address
First Line	:	415 SE 12TH ST
Second Line	:
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33316-1901
Country	:	US
Telephone Number	:	754-224-1555
Fax Number	:

Provider Business Practice Location Address
First Line	:	415 SE 12TH ST
Second Line	:
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33316-1901
Country	:	US
Telephone Number	:	754-224-1555
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/05/2016
Last Update Date	:	06/03/2026

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