LAKESIDE SMILES, LLC (NPI# 1841750965) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1841750965 |
| Entity Type | Organization |
| Organization Name | LAKESIDE SMILES, LLC |
| Practice Address |
7135 Minstrel Way Ste 101 Columbia MD 21045-5293 |
| Mailing Address |
11716 Pindell Chase Dr Fulton MD 20759-9704 |
| Practice Telephone | 4438323305 |
| Mailing Telephone | 7039438360 |
| Enumeration Date | 2019-03-24 |
| Last Update Date | 2019-10-16 |
| Authorized Official Name | KATHY DIPASQUALE KIM (OWNER, DENTIST) |
| Authorized Official Telephone | 4439799155 |
| Authorized Official Credential | DDS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
Dental Providers |
| Street Address |
7135 MINSTREL WAY STE 101 |
| City | COLUMBIA |
| State | MD |
| Zip Code | 21045-5293 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497374136 | Keenan Eldridge | Behavior Technician | 8950 Md-108, Suite 100, Columbia, MD 21045 | 2020-04-13 |
| 1730724220 | Luci Lee Redman Cassella | Family Medicine | 8900 Columbia 100 Parway Suite G, Columbia, MD 21045 | 2019-11-08 |
| 1417519414 | Howard County Health Department | Clinic/Center | Cradlerock Elementary School-based Wellness Center, 6700 Cradlerock Way, Columbia, MD 21045 | 2019-07-01 |
| 1649754490 | Dana Pirzchalski | Behavioral Analyst | 8815 Columbia Parkwary, 4, Columbia, MD 21045 | 2018-09-18 |
| 1871089177 | Melissa Jo Kennedy | Behavior Technician | 8815 Columbia Parkway, 4, Columbia, MD 21045 | 2018-07-10 |
| 1497246193 | Kjd | Physical Therapist | 8900 Columbia 100 Pkwy Ste C, Columbia, MD 21045 | 2018-05-29 |
| 1174010276 | Roger Lee | Audiologist | 8600 Snowden River Pkwy #309, Columbia, MD 21045 | 2018-04-16 |
| 1811497910 | Dominique Nichole Hale | Behavior Technician | 8115 Columbia 100 Parkway, Suite 4, Columbia, MD 21045 | 2018-02-15 |
| 1982116802 | Bradley D. Stiles | Acupuncturist | 6257 Deep River Cyn, Columbia, MD 21045 | 2017-11-01 |
| 1194234849 | University of Maryland Eye Associates, P.a. | Eyewear Supplier (Equipment, not the service) | 5900 Waterloo Road, Suite 230, Columbia, MD 21045 | 2017-09-26 |
| Find all providers in zip 21045 | ||||
| Taxonomy Code | 1223G0001X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | General Practice |
| A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. |
| Notes: Source: Academy of General Dentistry |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184239832 | Adam Wesley Gadbois | Dentist | 220 Diego Dr, Columbia, MO 65203-4919 | 2020-09-10 |
| 1841803855 | Craig Thomas Luskey | Dentist | 4500 Stuart St Fl 3, Columbia, SC 29207-5700 | 2020-08-28 |
| 1710505169 | Dentists of Devine, PC | Dentist | 4600 Devine St Ste B, Columbia, SC 29205-3617 | 2020-07-13 |
| 1134745227 | Kayla White | Dentist | 1401 Forum Blvd Ste 203, Columbia, MO 65203-1915 | 2020-06-24 |
| 1962033001 | Ivy Creek Family Dentistry LLC | Dentist | 9007 Two Notch Rd Ste B, Columbia, SC 29223-5834 | 2020-01-28 |
| 1538701230 | Sulekha Agrawal Dmd LLC | Dentist | 9194 Red Branch Rd Ste A, Columbia, MD 21045-2005 | 2019-10-14 |
| 1619522794 | Timothy Drew Edwards | Dentist | 122 N. Brickyard Rd, Columbia, SC 29223 | 2019-08-06 |
| 1245885284 | Mana Shoeybi | Dentist | 6955 Oakland Mills Rd Ste 0, Columbia, MD 21045-5849 | 2019-08-06 |
| 1528628716 | Soh of Missouri Samson Liu PC | Dentist | 303 N Keene St # 202-210, Columbia, MO 65201-8050 | 2019-06-19 |
| 1417511783 | Molly Kayleen Pincelli | Dentist | Ph Usc Medical Group Dentistry, 10 Medical Park, Columbia, SC 29203 | 2019-04-23 |
| Find all providers in COLUMBIA | ||||
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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.