Lakeside ENT & Facial Plastic Surgery LLC

Primary specialty

Otolaryngology/Facial Plastic Surgery PhysicianTaxonomy code 207YX0905X

Legal business name

LAKESIDE ENT & FACIAL PLASTIC SURGERY LLC

Practice address

1516 4TH St NE
Watertown, SD 57201-6824

Phone

(605) 880-5965

NPI assigned

Oct 9, 2026

Last updated

Oct 9, 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

Dr. Jered M Mancell, DO

Title

Physician/Medical Director

Phone

(605) 880-5965

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1791504000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1791504000000",
    "number": "1578468591",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1516 4TH ST NE",
            "city": "WATERTOWN",
            "state": "SD",
            "postal_code": "572016824",
            "telephone_number": "605-880-5965"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1516 4TH ST NE",
            "city": "WATERTOWN",
            "state": "SD",
            "postal_code": "572016824",
            "telephone_number": "605-880-5965"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKESIDE ENT & FACIAL PLASTIC SURGERY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-10-09",
        "last_updated": "2026-10-09",
        "certification_date": "2026-10-09",
        "status": "A",
        "authorized_official_last_name": "MANCELL",
        "authorized_official_first_name": "JERED",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PHYSICIAN/MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "605-880-5965",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207YX0905X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Otolaryngology/Facial Plastic Surgery",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kunkel-Snyder Optometric, P.C
• Beth Ann Kunkel, O.D.
• Matthew Charles Kunkel, O.D.
• Roy Lagat
• Jacalynn L Lake, PT
• Lakeside Pain Center Prof. LLC
• Janet Lamb Even, LPC
• Zachary Eugene Lambrechts, DPT
• Janette Theresa Laplante, MS CCDC MAC
• Alyssa Larson

• Otolaryngology/Facial Plastic Surgery Physician in Watertown, SD
• Providers in Watertown, SD by specialty
• Otolaryngology/Facial Plastic Surgery Physician in South Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.