LAKEWOOD FAMILY DENTAL OF LAFAYETTE INC (NPI# 1487026431) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1487026431 |
| Entity Type | Organization |
| Organization Name | LAKEWOOD FAMILY DENTAL OF LAFAYETTE INC |
| Practice Address |
2 Executive Dr Lafayette IN 47905-4878 |
| Practice Telephone | 7658076666 |
| Mailing Telephone | 7658076666 |
| Enumeration Date | 2015-10-28 |
| Last Update Date | 2015-10-28 |
| Authorized Official Name | SRINIVASULU KAKOLLU (PRESIDENT) |
| Authorized Official Telephone | 7658076666 |
| Authorized Official Credential | DDS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 122300000X | Dentist | 12012121A | IN | Dental Providers |
| Street Address |
2 EXECUTIVE DR |
| City | LAFAYETTE |
| State | IN |
| Zip Code | 47905-4878 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972520997 | Wellbound of Lafayette LLC | Clinic/Center | 2 Executive Dr, Suite B, Lafayette, IN 47905-4878 | 2006-07-16 |
| 1982213245 | Chul Ho Yang | Dentist | 2 Executive Dr, Lafayette, IN 47905-4878 | 2020-07-23 |
| 1669025441 | Karthika Basireddy | Dentist | 2 Executive Dr, Lafayette, IN 47905-4878 | 2019-07-19 |
| 1801317573 | Virajitha Velichala | Dentist | 2 Executive Dr, Lafayette, IN 47905-4878 | 2017-07-03 |
| 1972685238 | Lafayette Oral and Maxillofacial Surgery Group, P.C. | Dentist | 2 Executive Dr, Suite A, Lafayette, IN 47905-4859 | 2006-10-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538719893 | Elements Counseling LLC | Social Worker | 115 N. Farabee Drive, Lafayette, IN 47905 | 2019-09-18 |
| 1134596869 | Indiana Dental Sleep Therapy LLC | Dentist | 4921 Sr 26 E, Suite 300, Lafayette, IN 47905 | 2015-08-28 |
| 1255750899 | Emily S Miller | Physical Therapist | 1701 Creasy Ln, Lafayette, IN 47905 | 2014-04-10 |
| 1073876215 | Nathan Webster | Dentist | 1530 Kossuth St., Lafayette, IN 47905 | 2012-06-22 |
| 1578848370 | Mark Jin Kim | Pharmacist | 1801 South St., Lafayette, IN 47905 | 2011-10-13 |
| 1700177185 | Shannon Tawn Harris | Speech-Language Pathologist | 8900 Cobbler Lane, Lafayette, IN 47905 | 2011-04-20 |
| 1508164484 | David Thomas Beine | Specialist/Technologist | 1321 Unity Pl Ste A, Lafayette, IN 47905 | 2011-03-02 |
| 1447569538 | Deidre Dudley | Nurse Practitioner | 1701 S Creasy Ln Ste 1w93, Lafayette, IN 47905 | 2010-10-07 |
| 1548493067 | Unity Healthcare, LLC | Podiatrist | 750 Park East Blvd, Unit 4, Lafayette, IN 47905 | 2009-09-01 |
| 1073762969 | Lynette Marie Alexander | Nurse Practitioner | 5500 St Rd. 38 East, Lafayette, IN 47905 | 2008-09-16 |
| Find all providers in zip 47905 | ||||
| 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 |
|---|---|---|---|---|
| 1801410931 | Briana Michelle Maddox | Dentist | 35 S Creasy Ln Ste 3, Lafayette, IN 47905-5254 | 2020-06-04 |
| 1366004186 | Hunter Brooks | Dentist | 107 Suwanee Rd, Lafayette, LA 70503-6111 | 2019-07-01 |
| 1952864654 | Laura Aguilar | Dentist | 3466 Mt Diablo Blvd Ste C207, Lafayette, CA 94549-7108 | 2019-04-09 |
| 1558852251 | Affordable Dentures & Implants - Lafayette, P.C. | Dentist | 4315 Commerce Dr Ste 210, Lafayette, IN 47905-3823 | 2018-05-29 |
| 1194246942 | Benjamin Isaac Fischer | Dentist | 415 N 26th St Ste 302, Lafayette, IN 47904-2893 | 2017-07-02 |
| 1912351941 | John Hyun-suk Kim | Dentist | 901 Moraga Rd Ste B, Lafayette, CA 94549-4567 | 2016-04-15 |
| 1912364241 | Maura Rose Darnieder | Dentist | 1285 Centaur Village Dr, Suite 200, Lafayette, CO 80026-1214 | 2016-01-17 |
| 1538530381 | Jacob Dent, Dds Lafayette Modern Dentistry, A Professional Corporation | Dentist | 4243 Ambassador Caffery Pkwy, Ste 118, Lafayette, LA 70508 | 2015-10-19 |
| 1134596869 | Indiana Dental Sleep Therapy LLC | Dentist | 4921 Sr 26 E, Suite 300, Lafayette, IN 47905 | 2015-08-28 |
| 1023484805 | Tyler Kellum Levie | Dentist | 201 E. Villanow Street, Lafayette, GA 30728 | 2015-08-17 |
| Find all providers in LAFAYETTE | ||||
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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.