Lakeside Family Dentistry, PLLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

6796 Issued in OK

Legal business name

LAKESIDE FAMILY DENTISTRY, PLLC

Practice address

2812 W Hefner Rd
Oklahoma City, OK 73120-6318

Phone

(405) 751-0358

NPI assigned

May 8, 2018

Organization subpart

No

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

Authorized official

Name

Kristen Johnson

Title

Business Advisor

Phone

(877) 221-7750

Specialties & licenses 1

Addresses

Locations

Practitioners 2

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

• Traci Leon, DDS

  • General Practice Dentistry
  • Oklahoma City, OK
  • NPI 1063963999
  NPD (past)
• Patrick Arthur Woods, DDS

  • General Practice Dentistry
  • Oklahoma City, OK
  • NPI 1346297884
  NPD (past)

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

{
    "created_epoch": "1525737600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1525737600000",
    "number": "1659860393",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2812 W HEFNER RD",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731206318",
            "telephone_number": "405-751-0358"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2812 W HEFNER RD",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731206318",
            "telephone_number": "405-751-0358"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKESIDE FAMILY DENTISTRY, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-05-08",
        "last_updated": "2018-05-08",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "KRISTEN",
        "authorized_official_title_or_position": "BUSINESS ADVISOR",
        "authorized_official_telephone_number": "877-221-7750"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "OK",
            "license": "6796",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lakepointe Imaging Center, LLC
• Lakepointe Open MRI, LLC
• Lakepointe Pet
• Lakepointe Pet, LLC
• Lakepointe Physical Therapy
• Lakeside Oral Surgery PLLC
• Lakeside Pediatrics PC
• Lakeside Women'S Center of Oklahoma City, LLC
• Lakeside Women'S Hospital, LLC
• Alexander Lakin

• General Practice Dentistry in Oklahoma City, OK
• Providers in Oklahoma City, OK by specialty
• General Practice Dentistry in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2018; 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.