NPIMap

Organization Active NPI

Lakeville Family Dental Center, P.L.L.C.

  • General Practice Dentistry
  • Lakeville, MN
National Provider Identifier
1063288017
Registry record updated Nov 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
LAKEVILLE FAMILY DENTAL CENTER, P.L.L.C.
Practice address
16372 Kenrick Ave Ste 200
Lakeville, MN 55044-3502
Phone
(952) 435-5905
NPI assigned
Nov 30, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 30, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Matthew Schneider, DDSNPI 1033555081
Title
Doctor
Phone
(952) 435-5905

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X Primary

Addresses

Primary practice location

16372 Kenrick Ave Ste 200
Lakeville, MN 55044-3502

Mailing address

16372 Kenrick Ave Ste 200
Lakeville, MN 55044-3502
Phone (952) 435-5905

National Provider Directory

National Provider Directory

Locations

16372 Kenrick Ave
Ste 200
Lakeville, MN 55044
Phone (952) 435-5905

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1701302400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1701302400000",
    "number": "1063288017",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16372 KENRICK AVE STE 200",
            "city": "LAKEVILLE",
            "state": "MN",
            "postal_code": "550443502",
            "telephone_number": "952-435-5905"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16372 KENRICK AVE STE 200",
            "city": "LAKEVILLE",
            "state": "MN",
            "postal_code": "550443502",
            "telephone_number": "952-435-5905"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKEVILLE FAMILY DENTAL CENTER, P.L.L.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-11-30",
        "last_updated": "2023-11-30",
        "certification_date": "2023-11-30",
        "status": "A",
        "authorized_official_last_name": "SCHNEIDER",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_title_or_position": "DOCTOR",
        "authorized_official_telephone_number": "952-435-5905",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakeville, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.