Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
LAKE STREET DENTAL
Active OrganizationLAKE STREET DENTAL is a Pediatric Dentistry organization located in MINNEAPOLIS, Minnesota. NPI 1184829509 is currently active in the NPPES registry. Verify at CMS.
Pediatric Dentistry · MINNEAPOLIS, MN
Registration Details
- NPI Number
- 1184829509
- Provider Type
- Organization
- NPI Issued
- Jun 16, 2007 (19.187725351916 yrs)
- Last Updated
- Sep 11, 2025
- Licenses
-
D11889 (MN)D11718 (MN)D12007 (MN)
Practice Information
- Address
-
1508 E LAKE STMINNEAPOLIS, MN, 554071720Browse MN providers · Browse ZIP 55407
- Phone
- 6127241717
- Primary Specialty
-
Pediatric Dentistry
1223P0700X
- Additional Specialty
- Periodontology
- Additional Specialty
- Pediatric Dentistry
Data sourced from the NPPES National Provider Identifier registry. Healthcare organizations registered in NPPES are assigned an NPI number for use in insurance billing and claims. This information is for informational purposes only. For official verification, use the NPPES NPI Registry.