Lake Country Dental P.L.L.C

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

License

050514 Issued in NY

Legal business name

LAKE COUNTRY DENTAL P.L.L.C

Practice address

404 William St Ste 5
Geneva, NY 14456-2143

Phone

(315) 789-3067

Fax

(315) 789-0056

NPI assigned

Jun 12, 2017

Organization subpart

No

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

Authorized official

Name

Dr. Lisa Kay Mulkin, D.D.S.NPI 1902916307

Title

Owner/Dentist

Phone

(315) 789-3067

Specialties & licenses 1

Addresses

Locations

Practitioners 2

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

• Lisa Kay Mulkin, D.D.S.

  • Oral and Maxillofacial Surgery (Dentist)
  • Geneva, NY
  • NPI 1902916307
  NPD Authorized official
• Ralph Defelice, DDS

  • General Practice Dentistry
  • Geneva, NY
  • NPI 1497964191
  NPD (past)

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

{
    "created_epoch": "1497225600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1396274452",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "404 WILLIAM ST STE 5",
            "city": "GENEVA",
            "state": "NY",
            "postal_code": "144562143",
            "telephone_number": "315-789-3067",
            "fax_number": "315-789-0056"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "404 WILLIAM ST STE 5",
            "city": "GENEVA",
            "state": "NY",
            "postal_code": "144562143",
            "telephone_number": "315-789-3067",
            "fax_number": "315-789-0056"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKE COUNTRY DENTAL P.L.L.C",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-06-12",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "MULKIN",
        "authorized_official_first_name": "LISA",
        "authorized_official_middle_name": "KAY",
        "authorized_official_title_or_position": "OWNER/DENTIST",
        "authorized_official_telephone_number": "315-789-3067",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "NY",
            "license": "050514",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shawn Kurian
• Meredith L Kyle, RPA-C
• Katheryn Anne L'Heureux, LCSW
• Julie A Labarr, RN
• Elizabeth Lafferty, OTR/L
• Lakeview Mental Health Services, Inc.
• Emily M Lambert, MD
• Beth A. Lanctot, PA-C
• Ann E. Landowne, MD
• Michele Laquidari, OPHTHALMIC DISPENSER

• Dental Clinic/Center in Geneva, NY
• Providers in Geneva, NY by specialty
• Dental Clinic/Center in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 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.