WATER'S EDGE DENTAL (NPI# 1790146587) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1790146587 |
| Entity Type | Organization |
| Organization Name | WATER'S EDGE DENTAL |
| Other Organization Name | LAKESIDE FAMILY DENTISTRY |
| Practice Address |
1880 W Wayzata Blvd Long Lake MN 55356-9491 |
| Mailing Address |
1880 W Wayzata Blvd P.o.box 128 Long Lake MN 55356-9491 |
| Practice Telephone | 9524750989 |
| Practice Fax Number | 9524752053 |
| Mailing Telephone | 9524750989 |
| Mailing Fax Number | 9524752053 |
| Enumeration Date | 2016-03-08 |
| Last Update Date | 2016-03-08 |
| Authorized Official Name | MR. MICHAEL E. GIEBENHAIN (OWNER) |
| Authorized Official Telephone | 9524750989 |
| Authorized Official Credential | D.D.S. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QD0000X |
Clinic/Center Specialization: Dental |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Lakeside Family Dentistry | Doing Business As Name - Organization |
| Street Address |
1880 W WAYZATA BLVD |
| City | LONG LAKE |
| State | MN |
| Zip Code | 55356-9491 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639242993 | Anthony Walter Boe | Dentist | 1880 W Wayzata Blvd, Long Lake, MN 55356-9491 | 2006-11-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497136014 | Brianna B. Hammer | Dentist | 2765 Kelley Parkway, Suite 140, Orono, MN 55356 | 2015-06-10 |
| 1336279926 | Nicholas John Froehling | Chiropractor | 2060 West Wayzata Blvd, Suite 150, Orono, MN 55356 | 2007-03-06 |
| 1871654343 | Thomas Lee Sawyer Jr. | Psychologist | 3405 Co Rd 6, Orono, MN 55356 | 2006-12-12 |
| 1851470314 | Long Lake Assisted Living | Assisted Living Facility | 345 N Brown Rd, Long Lake, MN 55356 | 2006-11-03 |
| 1679678973 | Douglas John Mcnaught | Dentist | 1870 W. Wayzata Blvd., Long Lake, MN 55356 | 2006-09-13 |
| 1245690874 | Diane Pease | Massage Therapist | 2160 W Wayzata Blvd, Long Lake, MN 55356-1100 | 2016-02-24 |
| 1902341589 | Michael Joseph Sherman | Massage Therapist | 1865 W Wayzata Blvd Ste 200, Long Lake, MN 55356-4100 | 2017-01-05 |
| 1376584656 | Michael W. Schwartz | Chiropractor | 1865 W Wayzata Blvd, Ste 200, Long Lake, MN 55356-4100 | 2006-06-09 |
| 1871025031 | Chirocenter Inc. | Chiropractor | 1865 W Wayzata Blvd Ste 200, Long Lake, MN 55356-4100 | 2017-03-28 |
| 1255791745 | West Lake Counseling and Wellness, Inc | Social Worker | 1613 W Wayzata Blvd Ste B, Long Lake, MN 55356-4103 | 2016-02-26 |
| Find all providers in zip 55356 | ||||
| Taxonomy Code | 261QD0000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Dental |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033710025 | Theresa M. Snell | Clinic/Center | 580 5th Ave Nw Ste 100, New Brighton, MN 55112-2836 | 2020-11-05 |
| 1376143248 | James M. Williams, D.d.s., P.a. | Clinic/Center | 620 Union St S, Mora, MN 55051-1818 | 2020-10-29 |
| 1235746058 | Asp Dental, PC | Clinic/Center | 17705 Hutchins Dr Ste 201, Minnetonka, MN 55345-4103 | 2020-09-25 |
| 1952918781 | Asp Dental, PC | Clinic/Center | 9800 Shelard Pkwy Ste 130, Plymouth, MN 55441-6451 | 2020-09-25 |
| 1518574532 | Stillwater Family Dental | Clinic/Center | 13481 60th St N Ste 100, Oak Park Heights, MN 55082-1089 | 2020-09-24 |
| 1093321531 | Barnett Dental Inc | Clinic/Center | 7962 Sunwood Dr Nw Ste 200, Ramsey, MN 55303-5172 | 2020-09-21 |
| 1356955868 | Todd A Brewer Dds Pllc | Clinic/Center | 603 Jefferson Ave Sw, Watertown, MN 55388 | 2020-09-02 |
| 1770195158 | Mark T. Sherman Dds Pa | Clinic/Center | 31011 Rasmussen Rd, Pequot Lakes, MN 56472-1227 | 2020-08-18 |
| 1689286015 | Lifelong Dental Care | Clinic/Center | 1525 Livingston Ave Ste B, West St Paul, MN 55118-3430 | 2020-08-18 |
| 1528678497 | Custom Smiles Dentistry, Pllc | Clinic/Center | 2258 Bunker Lake Blvd Nw, Andover, MN 55304-3900 | 2020-08-05 |
| Find all providers with the same taxonomy | ||||
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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.