LAKE MERIDIAN DENTAL LLC (NPI# 1093110215) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1093110215 |
| Entity Type | Organization |
| Organization Name | LAKE MERIDIAN DENTAL LLC |
| Other Organization Name | COMFORT DENTAL LAKE MERIDIAN |
| Practice Address |
12906 Se Kent Kangley Rd Kent WA 98030-7940 |
| Practice Telephone | 2536313015 |
| Mailing Telephone | 2536313015 |
| Enumeration Date | 2014-10-30 |
| Last Update Date | 2014-10-30 |
| Authorized Official Name | TRAVIS JOHN PROBST (DENTIST) |
| Authorized Official Telephone | 2536313015 |
| Authorized Official Credential | DDS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 122300000X | Dentist | DE60198294 | WA | Dental Providers |
| Other Name | Type Code |
|---|---|
| Comfort Dental Lake Meridian | Doing Business As Name - Organization |
| Street Address |
12906 SE KENT KANGLEY RD |
| City | KENT |
| State | WA |
| Zip Code | 98030-7940 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417309790 | Kooroush Mansourzadeh | Dentist | 12906 Se Kent Kangley Rd, Kent, WA 98030-7940 | 2016-07-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871193193 | Sarah V Swan | Occupational Therapist | 12033 Se 265th St, Kent, WA 98030 | 2020-10-27 |
| 1346889250 | Kaylee Meilahn | Nurse Practitioner | 219 State Ave. N, Suite 220, Kent, WA 98030 | 2019-12-26 |
| 1508417429 | Pamela Stefansky | Technician | 25927 119th Ct Se, Kent, WA 98030 | 2019-09-23 |
| 1144703885 | Healthpoint | Clinic/Center | 219 State Ave N, Ste 100, Kent, WA 98030 | 2018-09-10 |
| 1932681921 | Johana Sanchez-vidales | Massage Therapist | 24837 104th Ave Se #100, Kent, WA 98030 | 2018-09-05 |
| 1265925309 | Linda Tomkins | Chiropractor | 12901 Se Kent-kangley Rd, Kent, WA 98030 | 2018-06-13 |
| 1952809543 | Sarah Rose Collins | Massage Therapist | 13003 Se Kent Kangley Rd Ste 110, Kent, WA 98030 | 2018-01-29 |
| 1942726815 | Alexandra B Zigmont | Physical Therapist | 12926 Se Kent Kangley Road, Kent, WA 98030 | 2017-08-22 |
| 1659801256 | Mitra Lal Dhital | Counselor | 3639 Mlk Jr Way S Seattle, Seattle, WA 98030 | 2017-06-15 |
| 1952838658 | Elizabeth Burson | Registered Nurse | 25742 104th Avenue Se, Kent, WA 98030 | 2017-05-12 |
| Find all providers in zip 98030 | ||||
| Taxonomy Code | 122300000X |
| Grouping | Dental Providers |
| Classification | Dentist |
| A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336792118 | Gurpreet Kaur Shahi | Dentist | 9812 S 220th Pl, Kent, WA 98031-8112 | 2019-07-19 |
| 1053970210 | Mark Studeny Dds Pllc | Dentist | 18230 E Valley Hwy Ste 168, Kent, WA 98032-1231 | 2019-06-11 |
| 1174000467 | Jessica Elizabeth Wieker | Dentist | 940 Central Ave N Ste B, Kent, WA 98032-2052 | 2018-07-19 |
| 1548634231 | Rena Jhuty | Dentist | 11911 Se 245th Pl, Kent, WA 98030-9204 | 2015-11-18 |
| 1972986107 | Sue Kim | Dentist | 24128 130th Ave Se, Kent, WA 98030-9209 | 2015-07-07 |
| 1164804175 | Cuong Duy Nguyen | Dentist | 10032 Se 220th St, Kent, WA 98031-2510 | 2015-06-25 |
| 1083019210 | West Kent Dental LLC | Dentist | 23241 Pacific Hwy S, Kent, WA 98032-2721 | 2014-10-30 |
| 1487062816 | Tony Le | Dentist | 25248 Pacific Hwy S Ste 105, Kent, WA 98032-6530 | 2014-07-29 |
| 1982947107 | Kristin Lee Donaldson | Dentist | 1951 State Route 59 Ste B, Kent, OH 44240-8128 | 2013-04-05 |
| 1386959013 | Pawandeep Bajwa | Dentist | 27002 115th Pl Se, Kent, WA 98030-8783 | 2010-08-18 |
| Find all providers in KENT | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.