Lakeview Smiles Edgewater LTD

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

LAKEVIEW SMILES EDGEWATER LTD

Practice address

6351 N Broadway St Unit a
Chicago, IL 60660-1401

Phone

(312) 584-0510

Fax

(312) 584-0541

NPI assigned

Feb 22, 2022

Organization subpart

No

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

Authorized official

Name

Dr. Grace Lee, DDSNPI 1760673339

Title

President

Phone

(773) 929-1150

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.

• Grace H Lee, DDS

  • General Practice Dentistry
  • Riverdale, IL
  • NPI 1760673339
  NPD Authorized official
• Marissa Lauren Wadhwa, DMD

  • General Practice Dentistry
  • Chicago, IL
  • NPI 1003794983
  NPD (past)

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

{
    "created_epoch": "1645488000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1645488000000",
    "number": "1700532470",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6351 N BROADWAY ST UNIT A",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606601401",
            "telephone_number": "312-584-0510",
            "fax_number": "773-929-0831"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6351 N BROADWAY ST UNIT A",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606601401",
            "telephone_number": "312-584-0510",
            "fax_number": "312-584-0541"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKEVIEW SMILES EDGEWATER LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-02-22",
        "last_updated": "2022-02-22",
        "certification_date": "2022-02-22",
        "status": "A",
        "authorized_official_last_name": "LEE",
        "authorized_official_first_name": "GRACE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "773-929-1150",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lakeview Plastic Surgery, LLC
• Lakeview Psychiatry & Counseling
• Lakeview Psychology Group
• Lakeview Pulmonary & Sleep Consultants LTD
• Lakeview Rehabilitation and Nursing Center
• Lakeview Smiles Midway LTD
• Lakeview Speech and Language Clinic, LLC
• Lakeview Speech Therapy, LLC
• Lakeview Surgery Center
• Lakeview Womens Health SC

• Dental Clinic/Center in Chicago, IL
• Providers in Chicago, IL by specialty
• Dental Clinic/Center in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2022; 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.