Lake Meadow Dental Group PLLC

Primary specialty

DentistTaxonomy code 122300000X

License

11606 Issued in TX

Legal business name

LAKE MEADOW DENTAL GROUP PLLC

Practice address

9262 Forest LN Ste 100
Dallas, TX 75243-6237

Phone

(214) 349-2160

NPI assigned

Mar 16, 2018

Organization subpart

No

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

Authorized official

Name

Amanda Lightfoot

Title

Authorized Representative

Phone

(214) 702-0708

Specialties & licenses 1

Addresses

Practitioners 2

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

• David Howard Grinsfelder, DDS

  • General Practice Physician
  • Dallas, TX
  • NPI 1609976430
  NPD (past)
• Jennifer H Raad, DDS, MDS

  • Endodontics
  • Dallas, TX
  • NPI 1962819086
  NPD (past)

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

{
    "created_epoch": "1521158400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1683590400000",
    "number": "1578066403",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15660 DALLAS PKWY STE 925",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752483323",
            "telephone_number": "214-702-0720"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9262 FOREST LN STE 100",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752436237",
            "telephone_number": "214-349-2160"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKE MEADOW DENTAL GROUP PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-03-16",
        "last_updated": "2023-05-09",
        "certification_date": "2023-05-09",
        "status": "A",
        "authorized_official_last_name": "LIGHTFOOT",
        "authorized_official_first_name": "AMANDA",
        "authorized_official_title_or_position": "AUTHORIZED REPRESENTATIVE",
        "authorized_official_telephone_number": "214-702-0708"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "TX",
            "license": "11606",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lake Highlands Internal Medicine
• Lake House Home Health Agency, LLC
• Lake June Dental PLLC
• Lake June Medical Center, P.a.
• Lake June SRGM PLLC
• Lake Time Crna
• Amy Lake
• Kimberly J Lake, DDS
• Lakehill Preparatory School: Health and Wellness Center
• Lakeshia Kijuan Ealy

• Dentist in Dallas, TX
• Providers in Dallas, TX by specialty
• Dentist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2023; 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.