Lake City Dental P.L.L.C.

Primary specialty

DentistTaxonomy code 122300000X

Legal business name

LAKE CITY DENTAL P.L.L.C.

Practice address

210 N Lakeshore Dr
Lake City, MN 55041-1551

Phone

(651) 345-4677

NPI assigned

Sep 13, 2024

Last updated

Sep 13, 2024By 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. Thomas Lewis, DDSNPI 1477246569

Title

Owner/Dentist

Phone

(507) 993-4713

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, and the practitioner matching its NPPES authorized official.

• Thomas Lewis, DDS

  • Dentist
  • Spring Valley, MN
  • NPI 1477246569
  NPD Authorized official
• Scott Alan Knudsen, DDS

  • Dentist
  • Lake City, MN
  • NPI 1811069362
  NPD (past)

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

{
    "created_epoch": "1726185600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1726185600000",
    "number": "1740016898",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6037 S POINTE DR SW",
            "city": "ROCHESTER",
            "state": "MN",
            "postal_code": "559022545",
            "telephone_number": "507-993-4713"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 N LAKESHORE DR",
            "city": "LAKE CITY",
            "state": "MN",
            "postal_code": "550411551",
            "telephone_number": "651-345-4677"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKE CITY DENTAL P.L.L.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-09-13",
        "last_updated": "2024-09-13",
        "certification_date": "2024-09-12",
        "status": "A",
        "authorized_official_last_name": "LEWIS",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_title_or_position": "OWNER/DENTIST",
        "authorized_official_telephone_number": "507-993-4713",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mark Thomas Kennedy
• Scott Alan Knudsen, DDS
• McKenzie Marie Koch, OTD, OTR/L
• Lake City #813
• Lake City Chiropractic, LTD.
• Jody Leise, APRN, CNS
• Katherine Lillie Lofberg, FNP-C
• Ann Marie Lowe, M.D.
• Reid Lundell
• Mayo Clinic Health System-Lake City

• Dentist in Lake City, MN
• Providers in Lake City, MN by specialty
• Dentist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2024; 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.