Provider Demographics
NPI:1942092713
Name:DRADAK ENTERPRISES PLLC
Entity type:Organization
Organization Name:DRADAK ENTERPRISES PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:ASHLEY
Authorized Official - Middle Name:
Authorized Official - Last Name:CHANDLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:863-644-0430
Mailing Address - Street 1:330 E HIGHLAND DR
Mailing Address - Street 2:
Mailing Address - City:LAKELAND
Mailing Address - State:FL
Mailing Address - Zip Code:33813-1727
Mailing Address - Country:US
Mailing Address - Phone:863-644-0430
Mailing Address - Fax:863-646-5902
Practice Address - Street 1:401 S PARSONS AVE STE A
Practice Address - Street 2:
Practice Address - City:BRANDON
Practice Address - State:FL
Practice Address - Zip Code:33511-5241
Practice Address - Country:US
Practice Address - Phone:813-708-5237
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ADAK-2 ENTERPRISES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2025-05-19
Last Update Date:2025-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Single Specialty