Lakes Orthodontic Associates, P.a.

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

9462 Issued in MN

Legal business name

LAKES ORTHODONTIC ASSOCIATES, P.A.

Practice address

1668 Cope Ave E
Maplewood, MN 55109-2655

Phone

(651) 777-7300

Fax

(651) 777-9131

NPI assigned

Dec 19, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Kevin Lee Denis, DDS, MS

Title

Ceo

Phone

(651) 777-7300

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1166486400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1245393230",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1668 COPE AVE E",
            "city": "MAPLEWOOD",
            "state": "MN",
            "postal_code": "551092655",
            "telephone_number": "651-777-7300",
            "fax_number": "651-777-9131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1668 COPE AVE E",
            "city": "MAPLEWOOD",
            "state": "MN",
            "postal_code": "551092655",
            "telephone_number": "651-777-7300",
            "fax_number": "651-777-9131"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKES ORTHODONTIC ASSOCIATES, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-19",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "DENIS",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "651-777-7300",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS, MS"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "MN",
            "license": "9462",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Yekaterina Aleksandrovna Kuzmenko, M.D.
• John H Kvasnicka, MD
• Kristine Kathryn Labolt
• Suresh Lagalwar, MD
• Joshua Lai
• Joel Lambrides
• Shari L Landreville
• Dana Lange
• Thomas Curtis Langlois
• Andrew John Larson, MS, LPCC, LADC

• Orthodontics and Dentofacial Orthopedics Dentistry in Maplewood, MN
• Providers in Maplewood, MN by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.