Cedar Lake Dental Center, Inc.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

54000250A Issued in IN

Legal business name

CEDAR LAKE DENTAL CENTER, INC.

Practice address

13955 Morse St
Cedar Lake, IN 46303-9639

Phone

(219) 374-5591

Fax

(219) 662-2573

NPI assigned

Nov 1, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Richard Douglas Kazwell, D.D.S.

Title

President

Phone

(219) 374-5591

Specialties & licenses 1

Addresses

Practitioners 1

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

• Hany Hany Reyad, DMD

  • Dentist
  • Demotte, IN
  • NPI 1104319177
  NPD (past)

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1326126871",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13955 MORSE ST",
            "city": "CEDAR LAKE",
            "state": "IN",
            "postal_code": "463039639",
            "telephone_number": "219-374-5591",
            "fax_number": "219-662-2573"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13955 MORSE ST",
            "city": "CEDAR LAKE",
            "state": "IN",
            "postal_code": "463039639",
            "telephone_number": "219-374-5591",
            "fax_number": "219-662-2573"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CEDAR LAKE DENTAL CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-01",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "KAZWELL",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "DOUGLAS",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "219-374-5591",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "IN",
            "license": "54000250A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bernadette Bryant, COTA/L
• Sabrina Caparelli, DPT
• James Edward Carlson, D.O.
• Maureen Eileen Carroll, DC
• Jillian Carter
• Cedar Lake Dental, Inc.
• Zackary Thomas Collins, PHARMD.
• Robin L Dal Santo, COTA/L
• Clara Damarjian
• Jean Marie Decavitch, NP-C

• General Practice Dentistry in Cedar Lake, IN
• Providers in Cedar Lake, IN by specialty
• General Practice Dentistry in Indiana

• 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.