Lakes Regional Oral & Maxillofacial Surgery, PC

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

Legal business name

LAKES REGIONAL ORAL & MAXILLOFACIAL SURGERY, PC

Practice address

116 E 11TH St
Suite 203
Spencer, IA 51301-4364

Phone

(712) 264-8390

Fax

(712) 264-8391

NPI assigned

Nov 26, 2008

Organization subpart

No

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

Authorized official

Name

Steven R Evelhoch, MDNPI 1972667160

Title

Owner

Phone

(712) 264-8390

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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

• Steven R Evelhoch, MD

  • Oral & Maxillofacial Surgery (D.M.D.)
  • Peoria, IL
  • NPI 1972667160

  Oral and Maxillofacial Surgery

  NPD (past) Authorized official

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

{
    "created_epoch": "1227657600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1227657600000",
    "number": "1760637185",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "116 E 11TH ST",
            "address_2": "SUITE 203",
            "city": "SPENCER",
            "state": "IA",
            "postal_code": "513014364",
            "telephone_number": "712-264-8390",
            "fax_number": "712-264-8391"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "116 E 11TH ST",
            "address_2": "SUITE 203",
            "city": "SPENCER",
            "state": "IA",
            "postal_code": "513014364",
            "telephone_number": "712-264-8390",
            "fax_number": "712-264-8391"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKES REGIONAL ORAL & MAXILLOFACIAL SURGERY, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-11-26",
        "last_updated": "2008-11-26",
        "status": "A",
        "authorized_official_last_name": "EVELHOCH",
        "authorized_official_first_name": "STEVEN",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "712-264-8390",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "IA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Katie Krusen, LISW
• Rachael Marie Kunzmann, PT, DPT
• Avery Laabs, LMSW, IADC
• Jaime Lair, ATC
• Emily Lynn Lake, LPC
• Carol Ann Lamoureux-Lewallen, DNP. ARNP
• Lia Lee, LMHC
• Clarissa Leinbaugh
• Emilee Leiting, PT, DPT
• Lincare Inc.

• Oral and Maxillofacial Surgery (Dentist) in Spencer, IA
• Providers in Spencer, IA by specialty
• Oral and Maxillofacial Surgery (Dentist) in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 26, 2008; 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.