LAKESIDE DENTAL LLC (NPI# 1891262804) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1891262804 |
Entity Type | Organization |
Organization Name | LAKESIDE DENTAL LLC |
Practice Address |
1051 Western Ave Manchester ME 04351-3403 |
Mailing Address |
60 Willow Ln Portland ME 04102-2629 |
Practice Telephone | 2073100842 |
Mailing Telephone | 2073100842 |
Enumeration Date | 2018-10-29 |
Last Update Date | 2018-10-29 |
Authorized Official Name | DR. RYAN SALAMON (MANAGER) |
Authorized Official Telephone | 2073100842 |
Authorized Official Credential | DMD |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 261QD0000X |
Clinic/Center Specialization: Dental |
Ambulatory Health Care Facilities |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1003268608 | Lakeside Dental LLC | Dentist | 15775 Highway 16 E, Shirley, AR 72153-8930 | 2016-07-07 |
1518317858 | Lakeside Dental LLC | Dentist | 5600 W Brown Deer Rd, Suite 111, Milwaukee, WI 53223-2311 | 2016-06-17 |
Entity Type | Entity Name | Entity Address |
---|---|---|
Washington State Corporations | LAKESIDE DENTAL LLC | 15720 68th Ave W, Edmonds, WA 98026-4509 |
Street Address |
1051 WESTERN AVE |
City | MANCHESTER |
State | ME |
Zip Code | 04351-3403 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1609896646 | James B. Newton | Dentist | 1051 Western Ave, Manchester, ME 04351-0450 | 2006-07-20 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1497171318 | Peter J Volk | Family Medicine | 23 Bowdoin Street, Manchester, ME 04351 | 2014-03-17 |
1740563428 | Insight-premier Health LLC | Clinic/Center | 27 Bowdoin Street, Manchester, ME 04351 | 2011-09-20 |
1427353069 | Robin Page Dufour | Physical Therapist | 6 Rockwood Dr, Suite 2, Manchester, ME 04351 | 2011-01-12 |
1174839708 | Richard Ofoe Kavi | Pharmacist | 943 Western Ave, Manchester, ME 04351 | 2010-08-20 |
1700199031 | Neil A Graves | Pharmacist | 943 Western Ave., Manchester, ME 04351 | 2010-07-15 |
1427212059 | Dustin R Sulak | Family Medicine | 964 Western Ave., Manchester, ME 04351 | 2008-07-14 |
1437312295 | Crossroads Counseling Center Pllc | Social Worker | 726 Western Ave., Manchester, ME 04351 | 2008-07-02 |
1548453616 | Christopher Paul Beaudoin | Social Worker | 15 Range Way Suite 3, Manchester, ME 04351 | 2007-08-22 |
1275724288 | Shawn Kenneth Hodgdon | Social Worker | 726 Western Avenue, Manchester, ME 04351 | 2007-08-05 |
1790900512 | Scott A Hayward | Social Worker | 15 Range Way, Suite 3, Manchester, ME 04351 | 2007-04-16 |
Find all providers in zip 04351 |
Taxonomy Code | 261QD0000X |
Grouping | Ambulatory Health Care Facilities |
Classification | Clinic/Center |
Specialization | Dental |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1780006759 | Gentle Dental Associates, LLC | Clinic/Center | 801 Elm St, Manchester, NH 03101-2103 | 2014-01-10 |
1972147866 | Sunshine Dental of Manchester | Clinic/Center | 168 Spencer St, Manchester, CT 06040-4616 | 2019-11-04 |
1265073563 | North End Dental Care Pllc | Clinic/Center | 1361 Elm St Ste 202, Manchester, NH 03101-1323 | 2019-10-08 |
1447715602 | 42 North Dental | Clinic/Center | 238 Tolland Tpke, Manchester, CT 06042-1744 | 2019-02-01 |
1659858801 | Manchester Dental Surgery and Implant Center | Clinic/Center | 30 Canton St Ste 12, Manchester, NH 03103-3524 | 2018-07-20 |
1467960880 | Robert C. Fromuth Dds Pllc | Clinic/Center | 765 S Main St Ste 102, Manchester, NH 03102-5141 | 2018-01-19 |
1356854426 | Dr Dental of Manchester PC | Clinic/Center | 460 Elm St, Manchester, NH 03101-2701 | 2017-11-13 |
1760905830 | Bh Dental LLC | Clinic/Center | 194 Buckland Hills Dr Ste 1076, Manchester, CT 06042-8785 | 2017-07-20 |
1104205707 | Amoskeag Family Dentistry, LLP | Clinic/Center | 316 S Main St, Manchester, NH 03102-4842 | 2015-05-28 |
1548649890 | Audc Dental Group Pllc | Clinic/Center | 324 S Main St, Manchester, NH 03102-4842 | 2015-05-20 |
Find all providers in MANCHESTER |
City | MANCHESTER |
Zip Code | 04351 |
Please comment or provide details below to improve the information on LAKESIDE DENTAL LLC.
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.