NPIMap

Organization Active NPI

Lake City Dental

  • General Practice Dentistry
  • Lake City, FL
National Provider Identifier
1578840245
Registry record updated Nov 9, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DN18804 Issued in FL
Legal business name
LAKE CITY DENTAL
Practice address
844 S Marion Ave
Lake City, FL 32025-5855
Phone
(386) 752-8531
Fax
(386) 752-7681
NPI assigned
Nov 9, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 9, 2011

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

Authorized official

Name
Ms. Grace I Kraft
Title
Office Manager
Phone
(386) 752-8531

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X DN18804 FL Primary

Addresses

Primary practice location

844 S Marion Ave
Lake City, FL 32025-5855

Mailing address

844 S Marion Ave
Lake City, FL 32025-5855
Phone (386) 752-8531

National Provider Directory

National Provider Directory

Locations

844 S Marion Ave
Lake City, FL 32025
Phone (386) 752-8531

Practitioners & affiliated clinicians

Practitioners 4

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

NPI Registry JSON

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

{
    "created_epoch": "1320796800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1320796800000",
    "number": "1578840245",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "844 S MARION AVE",
            "city": "LAKE CITY",
            "state": "FL",
            "postal_code": "320255855",
            "telephone_number": "386-752-8531",
            "fax_number": "386-752-7681"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "844 S MARION AVE",
            "city": "LAKE CITY",
            "state": "FL",
            "postal_code": "320255855",
            "telephone_number": "386-752-8531",
            "fax_number": "386-752-7681"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKE CITY DENTAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-11-09",
        "last_updated": "2011-11-09",
        "status": "A",
        "authorized_official_last_name": "KRAFT",
        "authorized_official_first_name": "GRACE",
        "authorized_official_middle_name": "I",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "386-752-8531",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN18804",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake City, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2011; 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.