Fountain Lake Family Dental

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

FOUNTAIN LAKE FAMILY DENTAL

Doing business as

Fountain Lake Family Dental

Practice address

146 W Clark St
Albert Lea, MN 56007-2546

Phone

(507) 373-3323

Fax

(507) 373-4513

NPI assigned

Jul 30, 2020

Organization subpart

No

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

Authorized official

Name

Karisa Lehmann

Title

Office Manager

Phone

(507) 373-3323

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Fountain Lake Family Dental Doing business as

Electronic endpoints 1

Locations

Practitioners 1

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

• Seth Huiras, D.D.S.

  • Dentist
  • Montgomery, MN
  • NPI 1205217106
  NPD

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

{
    "created_epoch": "1596067200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1596067200000",
    "number": "1104435585",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "146 W CLARK ST",
            "city": "ALBERT LEA",
            "state": "MN",
            "postal_code": "560072546",
            "telephone_number": "507-373-3323"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "146 W CLARK ST",
            "city": "ALBERT LEA",
            "state": "MN",
            "postal_code": "560072546",
            "telephone_number": "507-373-3323",
            "fax_number": "507-373-4513"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOUNTAIN LAKE FAMILY DENTAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-07-30",
        "last_updated": "2020-07-30",
        "certification_date": "2020-07-30",
        "status": "A",
        "authorized_official_last_name": "LEHMANN",
        "authorized_official_first_name": "KARISA",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "507-373-3323"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MINNESOTA",
            "identifier": "D13630",
            "state": "MN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "smiles@fountainlakefamilydental.net",
            "affiliation": "N",
            "address_1": "146 W Clark St",
            "city": "Albert Lea",
            "state": "MN",
            "country_code": "US",
            "postal_code": "560072546",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Fountain Lake Family Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Kim Flaa
• Samantha Flaa
• Thomas Andrew Flamm, P.A.
• Albert David Flor, DDS
• Forefront Dermatology, S.C.
• Freeborn County Alcoholic Referral Center, Inc (Freeborn County Chemical Dependency Center)
• Anne Louise Gallion, MD
• John Zheng Gao, MD
• Gentle Guidance LLC (Abigail Goskeson)
• Cynthia R Gilbert, PA-C

• Dental Clinic/Center in Albert Lea, MN
• Providers in Albert Lea, MN by specialty
• Dental Clinic/Center in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2020; 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.