LAKES REGIONAL ORAL & MAXILLOFACIAL SURGERY, PC (NPI# 1760637185) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1760637185 |
Entity Type | Organization |
Organization Name | LAKES REGIONAL ORAL & MAXILLOFACIAL SURGERY, PC |
Practice Address |
116 E 11th St Suite 203 Spencer IA 51301-4364 |
Practice Telephone | 7122648390 |
Practice Fax Number | 7122648391 |
Mailing Telephone | 7122648390 |
Mailing Fax Number | 7122648391 |
Enumeration Date | 2008-11-26 |
Last Update Date | 2008-11-26 |
Authorized Official Name | STEVEN R EVELHOCH (OWNER) |
Authorized Official Telephone | 7122648390 |
Authorized Official Credential | MD |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 1223S0112X |
Dentist Specialization: Oral and Maxillofacial Surgery |
IA | Dental Providers |
Street Address |
116 E 11TH ST SUITE 203 |
City | SPENCER |
State | IA |
Zip Code | 51301-4364 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1598760605 | John Benjamin Synhorst II | Dentist | 116 E 11th St, Ste 201, Spencer, IA 51301-4363 | 2005-06-15 |
1467821116 | Briana Wetrich | Physician Assistant | 116 E 11th St, Suite 101, Spencer, IA 51301-4300 | 2015-09-23 |
1780062273 | Spencer Municipal Hospital | Family Medicine | 116 E 11th St, Suite 101, Spencer, IA 51301-4365 | 2015-05-15 |
1720401961 | Megan Vanotterloo | Nurse Practitioner | 116 E 11th St, Suite 101, Spencer, IA 51301-4300 | 2014-01-23 |
1225468812 | Karen Potaczek, D.d.s., P.C. | Oral & Maxillofacial Surgery | 116 E 11th St, Suite 201, Spencer, IA 51301-4393 | 2013-11-18 |
1386938926 | Hilary L Kerrick | Family Medicine | 116 E 11th St, Suite 101, Spencer, IA 51301-4300 | 2011-05-31 |
1144534702 | Avera Home Medical Equipment of Spencer Hospital LLC | Durable Medical Equipment & Medical Supplies | 116 E 11th St, Suite 104, Spencer, IA 51301-4300 | 2010-08-05 |
1669793808 | David Stephen Keith | Family Medicine | 116 E 11th St, Suite 101, Spencer, IA 51301-4300 | 2010-06-22 |
1124344833 | Travis J. Witt | Family Medicine | 116 E 11th St, Suite 101, Spencer, IA 51301-4300 | 2010-04-20 |
1003046939 | Kathi Kae Heckert | Nurse Practitioner | 116 E 11th St, Ste 101, Spencer, IA 51301-4300 | 2009-07-27 |
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NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1508331877 | Angie Marie Wigen | Occupational Therapy Assistant | 1202 11 Th Ave Se, Spencer, IA 51301 | 2018-10-12 |
1184040511 | Leisha Fischer | Nurse Practitioner | 116 East 7th Street, Suite 2, Spencer, IA 51301 | 2014-03-10 |
1427482199 | Mark Alan De Ruyter | Social Worker | 116 E. 11th St., Spencer, IA 51301 | 2013-08-29 |
1467894873 | Daniel Wesley Abbott | Pathology | 116 E 11th St Ste 204, Spencer, IA 51301 | 2013-07-26 |
1730437542 | Spencer Convenient Healthcare LLC | Clinic/Center | 116 E. 7th Street, Suite 2, Spencer, IA 51301 | 2012-08-28 |
1114065109 | David W Lawrence | Audiologist-Hearing Aid Fitter | 920 North Grand Ave., Spencer, IA 51301 | 2007-02-02 |
1548328925 | Burns Chiropractic Center P C | Chiropractor | 1210 West 18th St, Spencer, IA 51301 | 2006-12-05 |
1073692661 | Gary Vanhofwegen | Dentist | 18 West 4th St, Spencer, IA 51301 | 2006-11-03 |
1952494114 | Medicap Pharmacy | Pharmacy | 829 Grand Ave N, Spencer, IA 51301 | 2006-10-02 |
1326131012 | Douglas J Schwartz | Chiropractor | 1204 West 18th St, Spencer, IA 51301 | 2006-10-02 |
Find all providers in zip 51301 |
Taxonomy Code | 1223S0112X |
Grouping | Dental Providers |
Classification | Dentist |
Specialization | Oral and Maxillofacial Surgery |
The specialty of dentistry which includes the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region. |
Notes: Source: Council on Dental Education and Licensure, American Dental Association |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1073532644 | Melanie Kristen Marshall | Dentist | 902 S Salisbury Ave, Spencer, NC 28159-2065 | 2006-07-18 |
1598760605 | John Benjamin Synhorst II | Dentist | 116 E 11th St, Ste 201, Spencer, IA 51301-4363 | 2005-06-15 |
1073782033 | Melanie K. Marshall, Dds, Md, Pa | Dentist | 902 S Salisbury Ave, Spencer, NC 28159-2065 | 2008-02-25 |
1700089513 | Karen Potaczek | Dentist | 116 E 11th St, Suite 201, Spencer, IA 51301-4393 | 2007-06-08 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1154970655 | Advanced Oral Surgery, Pllc | Dentist | 3265 S 24th St, Council Bluffs, IA 51501-6901 | 2019-09-06 |
1528421237 | Timothy Scott Albright | Dentist | 2814 Northgate Dr Ste 2, Iowa City, IA 52245-9513 | 2016-03-30 |
1467846519 | Edward H Schaefer Iv | Dentist | 201 Ridge St Ste 308, Council Bluffs, IA 51503-4643 | 2015-03-26 |
1386087658 | Michael Morio | Dentist | 7400 Fleur Dr Ste 200, Des Moines, IA 50321-3105 | 2013-04-16 |
1245550003 | Douglas Kendrick | Dentist | 451 Dental Science Bldg S, Iowa City, IA 52242-1001 | 2010-06-03 |
1013234194 | Ryan Norman Borgwardt | Dentist | 820 Fisher Drive, Waterloo, IA 50701 | 2010-04-28 |
1689802910 | Benjamin Luke Fuller | Dentist | 835 3rd Ave Sw, Cedar Rapids, IA 52404-1810 | 2009-06-25 |
1801093067 | Ryan A Marsh | Dentist | 7400 Fleur Dr, Ste 200, Des Moines, IA 50321-3105 | 2007-06-29 |
1386847630 | John D. Janulewicz | Dentist | 7400 Fleur Drive, Suite 200, Des Moines, IA 50321-3104 | 2007-06-06 |
1396952297 | Jonathan R Dejong | Dentist | 804 Kenyon Rd Ste 120, Fort Dodge, IA 50501-5746 | 2007-05-17 |
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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.