NPIMap

Organization Active NPI

Lakeland Family Dental

  • General Practice Dentistry
  • Rathdrum, ID
National Provider Identifier
1467324749
Registry record updated Sep 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
LAKELAND FAMILY DENTAL
Practice address
14596 Id-41
Rathdrum, ID 83858-1030
Phone
(208) 687-4455
NPI assigned
Sep 18, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 18, 2025

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

Authorized official

Name
Kyra Devore
Title
Office Manager
Phone
(208) 687-4455

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X Primary

Addresses

Primary practice location

14596 Id-41
Rathdrum, ID 83858-1030

Mailing address

PO Box 1030
Rathdrum, ID 83858-1030

National Provider Directory

National Provider Directory

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1758153600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1758153600000",
    "number": "1467324749",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1030",
            "city": "RATHDRUM",
            "state": "ID",
            "postal_code": "838581030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14596 ID-41",
            "city": "RATHDRUM",
            "state": "ID",
            "postal_code": "838581030",
            "telephone_number": "208-687-4455"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKELAND FAMILY DENTAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-09-18",
        "last_updated": "2025-09-18",
        "certification_date": "2025-09-04",
        "status": "A",
        "authorized_official_last_name": "DEVORE",
        "authorized_official_first_name": "KYRA",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "208-687-4455"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rathdrum, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2025; 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.