Organization Active NPI

Lakewood Dental Excellence, P.a.

  • Dental Clinic/Center
  • Bradenton, FL
National Provider Identifier
1295483956
Registry record updated Mar 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
Legal business name
LAKEWOOD DENTAL EXCELLENCE, P.A.
Practice address
5255 Office Park Blvd Ste 112
Bradenton, FL 34203-3443
Phone
(941) 739-7770
Fax
(941) 739-7770
NPI assigned
Mar 12, 2022
Last updated
Mar 12, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 12, 2022

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

Authorized official

Name
Richard M Kernagis, DMD
Title
President
Phone
(941) 739-7770

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X Primary

Addresses

Primary practice location

5255 Office Park Blvd Ste 112
Bradenton, FL 34203-3443

Mailing address

5255 Office Park Blvd Ste 112
Bradenton, FL 34203-3443
Phone (941) 739-7770

National Provider Directory

National Provider Directory

Locations

5255 Office Park Blvd
Ste 112
Bradenton, FL 34203
Phone (941) 739-7770

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1647043200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1647043200000",
    "number": "1295483956",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5255 OFFICE PARK BLVD STE 112",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342033443",
            "telephone_number": "941-739-7770",
            "fax_number": "941-739-7770"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5255 OFFICE PARK BLVD STE 112",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342033443",
            "telephone_number": "941-739-7770",
            "fax_number": "941-739-7770"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKEWOOD DENTAL EXCELLENCE, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-03-12",
        "last_updated": "2022-03-12",
        "certification_date": "2022-03-12",
        "status": "A",
        "authorized_official_last_name": "KERNAGIS",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "941-739-7770",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bradenton, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2022; 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.