Provider Demographics
NPI:1730980996
Name:ROARING SMILES DENTISTRY, LLC
Entity type:Organization
Organization Name:ROARING SMILES DENTISTRY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:LALINDA
Authorized Official - Middle Name:
Authorized Official - Last Name:WICKRAMASINGHE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:858-222-7276
Mailing Address - Street 1:558 WESTERN AVE
Mailing Address - Street 2:
Mailing Address - City:RANDOM LAKE
Mailing Address - State:WI
Mailing Address - Zip Code:53075-1737
Mailing Address - Country:US
Mailing Address - Phone:858-222-7276
Mailing Address - Fax:
Practice Address - Street 1:333 W BROWN DEER RD STE A
Practice Address - Street 2:
Practice Address - City:FOX POINT
Practice Address - State:WI
Practice Address - Zip Code:53217-2370
Practice Address - Country:US
Practice Address - Phone:858-222-7276
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?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental