Five Lakes Dental Studio LLC

Primary specialty

Dental LaboratoryTaxonomy code 292200000X

Legal business name

FIVE LAKES DENTAL STUDIO LLC

Practice address

31 Downtown PLZ
Fairmont, MN 56031-1702

Phone

(507) 235-9040

NPI assigned

Jun 17, 2026

Last updated

Jun 17, 2026By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Jeremy Joseph Stauffer, CDT

Title

Owner/Ceramist

Phone

(507) 235-9040

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1781654400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1781654400000",
    "number": "1497680656",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31 DOWNTOWN PLZ",
            "city": "FAIRMONT",
            "state": "MN",
            "postal_code": "560311702",
            "telephone_number": "507-235-9040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31 DOWNTOWN PLZ",
            "city": "FAIRMONT",
            "state": "MN",
            "postal_code": "560311702",
            "telephone_number": "507-235-9040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FIVE LAKES DENTAL STUDIO LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-06-17",
        "last_updated": "2026-06-17",
        "certification_date": "2026-06-17",
        "status": "A",
        "authorized_official_last_name": "STAUFFER",
        "authorized_official_first_name": "JEREMY",
        "authorized_official_middle_name": "JOSEPH",
        "authorized_official_title_or_position": "OWNER/CERAMIST",
        "authorized_official_telephone_number": "507-235-9040",
        "authorized_official_credential": "CDT"
    },
    "taxonomies": [
        {
            "code": "292200000X",
            "taxonomy_group": "",
            "desc": "Dental Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Fairmont Orthopedics & Sports Medicine P a (Center for Specialty Care)
• Fairmont Orthopedics & Sports Medicine, PA (Center for Specialty Care)
• Fairmont Orthopedics & Sports Medicine, PA (Center for Specialty Care)
• Samantha Augusta Farnum, APRN
• Robert Fernandez, MD
• Daniel Jeffrey Fordice, D.M.D.
• Jeffrey Howard Fordice, DDS
• Taylor Forstner, DDS
• Amanda J Forstrom, PT
• Robert Friese, OD

• Dental Laboratory in Fairmont, MN
• Providers in Fairmont, MN by specialty
• Dental Laboratory in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2026; 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.