Provider Demographics
NPI:1053112078
Name:LOTUS DENTAL HEALTH PARTNERS LLC
Entity type:Organization
Organization Name:LOTUS DENTAL HEALTH PARTNERS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:AZIZA
Authorized Official - Middle Name:B
Authorized Official - Last Name:ABED
Authorized Official - Suffix:
Authorized Official - Credentials:RDH
Authorized Official - Phone:440-829-4628
Mailing Address - Street 1:36701 AMERICAN WAY STE 1
Mailing Address - Street 2:
Mailing Address - City:AVON
Mailing Address - State:OH
Mailing Address - Zip Code:44011-4064
Mailing Address - Country:US
Mailing Address - Phone:440-937-8550
Mailing Address - Fax:
Practice Address - Street 1:1366 ETY RD NW
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:OH
Practice Address - Zip Code:43130-7765
Practice Address - Country:US
Practice Address - Phone:440-829-4628
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-03-24
Last Update Date:2025-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty