Minnesota Lakes Dental, PLLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

MINNESOTA LAKES DENTAL, PLLC

Practice address

4270 Maine Ave SE Ste 200
Rochester, MN 55904-6936

Phone

(507) 282-4401

Fax

(507) 282-4407

NPI assigned

Dec 9, 2020

Last updated

Dec 9, 2020By 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

Marshall Morris, DDSNPI 1184768681

Title

Owner/Dentist

Phone

(507) 282-4401

Specialties & licenses 1

Addresses

Electronic endpoints 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Marshall Allen Morris, DDS

  • General Practice Dentistry
  • Rochester, MN
  • NPI 1184768681
  NPD Authorized official

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

{
    "created_epoch": "1607472000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1607472000000",
    "number": "1538765029",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4270 MAINE AVE SE STE 200",
            "city": "ROCHESTER",
            "state": "MN",
            "postal_code": "559046936",
            "telephone_number": "507-282-4401",
            "fax_number": "507-282-4407"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4270 MAINE AVE SE STE 200",
            "city": "ROCHESTER",
            "state": "MN",
            "postal_code": "559046936",
            "telephone_number": "507-282-4401",
            "fax_number": "507-282-4407"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MINNESOTA LAKES DENTAL, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-12-09",
        "last_updated": "2020-12-09",
        "certification_date": "2020-12-09",
        "status": "A",
        "authorized_official_last_name": "MORRIS",
        "authorized_official_first_name": "MARSHALL",
        "authorized_official_title_or_position": "OWNER/DENTIST",
        "authorized_official_telephone_number": "507-282-4401",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "mnlakesdental@gmail.com",
            "affiliation": "N",
            "address_1": "4270 Maine Ave SE Ste 200",
            "city": "Rochester",
            "state": "MN",
            "country_code": "US",
            "postal_code": "559046936",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Amanda Mindela, LICSW
• Minneapolis Vamc
• Minnesota Adult Day Center, LLC
• Minnesota Dental Professionals, P.C. (Badger Hills Dental Care)
• Minnesota Immigrant Services
• Minnesota Mobile Exams LLC
• Minnesota Sleep Dentistry PLLC
• Minnesota Sleep Dentistry PLLC
• Minnesota Southeast Asian Home Care Inc.
• Minnesota State Colleges and Universities - Rochester Community & Tech (RCTC Dental Hygiene Clinic)

• General Practice Dentistry in Rochester, MN
• Providers in Rochester, 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 Dec 9, 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.