Lakeside Dental Group

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DN11243 Issued in FL

Legal business name

LAKESIDE DENTAL GROUP

Doing business as

Transitional Smiles Dental

Practice address

1015 N State Road 7
Suite B
Royal Palm Beach, FL 33411-5185

Phone

(561) 753-6633

Fax

(561) 753-6391

NPI assigned

Jun 18, 2009

Organization subpart

No

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

Authorized official

Name

Dr. Gina D Dean, D.D.S.

Title

Owner

Phone

(561) 753-6633

Specialties & licenses 3

Addresses

Other names 1

• Transitional Smiles Dental Doing business as

Locations

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

{
    "created_epoch": "1245283200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1245283200000",
    "number": "1558598409",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1015 N STATE ROAD 7",
            "address_2": "SUITE B",
            "city": "ROYAL PALM BEACH",
            "state": "FL",
            "postal_code": "334115185",
            "telephone_number": "561-753-6633",
            "fax_number": "561-753-6391"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1015 N STATE ROAD 7",
            "address_2": "SUITE B",
            "city": "ROYAL PALM BEACH",
            "state": "FL",
            "postal_code": "334115185",
            "telephone_number": "561-753-6633",
            "fax_number": "561-753-6391"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKESIDE DENTAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-06-18",
        "last_updated": "2009-06-18",
        "status": "A",
        "authorized_official_last_name": "DEAN",
        "authorized_official_first_name": "GINA",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "561-753-6633",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN11243",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN15914",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "FL",
            "license": "DN11236",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Transitional Smiles Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• General Practice Dentistry in Royal Palm Beach, FL
• Providers in Royal Palm Beach, FL by specialty
• General Practice Dentistry in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2009; 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.