Lakes Area Mobile Smiles, Inc

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D12159 Issued in MN

Legal business name

LAKES AREA MOBILE SMILES, INC

Doing business as

Lakes Mobile Dental

Practice address

22187 State Highway 6
Deerwood, MN 56444-6279

Phone

(218) 831-3131

Fax

(612) 235-3391

NPI assigned

Mar 27, 2007

Organization subpart

No

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

Authorized official

Name

Mrs. Rebecca Leigh Wilson, RDHNPI 1548388465

Title

President

Phone

(218) 831-3131

Specialties & licenses 1

Addresses

Other names 1

• Lakes Mobile Dental Doing business as

Practitioners 1

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

• Rebecca Leigh Wilson, RDH

  • Dental Hygienist
  • Deerwood, MN
  • NPI 1548388465
  NPD (past) Authorized official

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

{
    "created_epoch": "1174953600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1207785600000",
    "number": "1508984410",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22187 STATE HIGHWAY 6",
            "city": "DEERWOOD",
            "state": "MN",
            "postal_code": "564446279",
            "telephone_number": "218-831-3131",
            "fax_number": "612-235-3391"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22187 STATE HIGHWAY 6",
            "city": "DEERWOOD",
            "state": "MN",
            "postal_code": "564446279",
            "telephone_number": "218-831-3131",
            "fax_number": "612-235-3391"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKES AREA MOBILE SMILES, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-27",
        "last_updated": "2008-04-10",
        "status": "A",
        "authorized_official_last_name": "WILSON",
        "authorized_official_first_name": "REBECCA",
        "authorized_official_middle_name": "LEIGH",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "218-831-3131",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "RDH"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "MN",
            "license": "D12159",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lakes Mobile Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Cummings Treasured Time Adult Day Center LLC
• Kendall Lewis Dammeier, DDS
• Rachael Ann Darling
• Deerwood Dental, Inc (The Smile Center)
• Molly Rebecca Gervich, DDS
• Jamie Don Lauwagie, MD
• Minnesota Mobility Systems Inc.
• Shelly A..J. Neiman, CNP
• Northland Smiles Corporation PA
• Bradford J Pugh, DDS

• General Practice Dentistry in Deerwood, MN
• Providers in Deerwood, MN by specialty
• General Practice Dentistry in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2008; 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.