Great Lakes Dentalof Westlake LLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

022436 Issued in OH

Legal business name

GREAT LAKES DENTALOF WESTLAKE LLC

Practice address

25101 Detroit Rd
Suite 445
Westlake, OH 44145-2552

Phone

(440) 617-9429

Fax

(440) 617-9457

NPI assigned

Aug 31, 2010

Organization subpart

No

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

Authorized official

Name

Stafani Sandoval

Title

Insurance Specialist

Phone

(440) 356-2089

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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

• Paul Willard Lindgren, DDS

  • General Practice Dentistry
  • Westlake, OH
  • NPI 1912003302
  NPD (past)

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

{
    "created_epoch": "1283212800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1627430400000",
    "number": "1316253149",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19111 DETROIT RD STE 206",
            "city": "ROCKY RIVER",
            "state": "OH",
            "postal_code": "441161740",
            "telephone_number": "440-617-9429",
            "fax_number": "440-356-2090"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25101 DETROIT RD",
            "address_2": "SUITE 445",
            "city": "WESTLAKE",
            "state": "OH",
            "postal_code": "441452552",
            "telephone_number": "440-617-9429",
            "fax_number": "440-617-9457"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREAT LAKES DENTALOF WESTLAKE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-08-31",
        "last_updated": "2021-07-28",
        "certification_date": "2021-07-28",
        "status": "A",
        "authorized_official_last_name": "SANDOVAL",
        "authorized_official_first_name": "STAFANI",
        "authorized_official_title_or_position": "INSURANCE SPECIALIST",
        "authorized_official_telephone_number": "440-356-2089"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "OH",
            "license": "022436",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Macie Graham, RBT
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• Colleen Gray, CCC/SLP
• Robert Simpson Gray Jr., ATC
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• Nancy L Grech, NP-C
• Mary Kay Greenberg, MD
• Alexandria Greene
• Gregory Greene, DO

• General Practice Dentistry in Westlake, OH
• Providers in Westlake, OH by specialty
• General Practice Dentistry in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2021; 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.