Lake Jackson Modern Dentistry, PC

Primary specialty

DentistTaxonomy code 122300000X

Legal business name

LAKE JACKSON MODERN DENTISTRY, PC

Doing business as

Lake Jackson Modern Dentistry

Practice address

17000 Red Hill Ave
Irvine, CA 92614-5626

Phone

(714) 845-8890

Fax

(949) 474-1495

NPI assigned

Jul 13, 2015

Organization subpart

No

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

Authorized official

Name

Dr. John S Barnes, DDS

Title

Owner Doctor

Phone

(979) 583-6005

Specialties & licenses 1

Addresses

Other names 1

• Lake Jackson Modern Dentistry Doing business as

Locations

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

{
    "created_epoch": "1436745600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1436745600000",
    "number": "1821472507",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "97 OYSTER CREEK DR SUITE 130",
            "city": "LAKE JACKSON",
            "state": "TX",
            "postal_code": "77566",
            "telephone_number": "979-583-6005",
            "fax_number": "979-583-6680"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17000 RED HILL AVE",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926145626",
            "telephone_number": "714-845-8890",
            "fax_number": "949-474-1495"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKE JACKSON MODERN DENTISTRY, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-07-13",
        "last_updated": "2015-07-13",
        "status": "A",
        "authorized_official_last_name": "BARNES",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "OWNER DOCTOR",
        "authorized_official_telephone_number": "979-583-6005",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lake Jackson Modern Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Tsu H Lai, M.D.
• Laila Elkeeb, M.D., Inc
• Lindsey Michelle Laing, M.S., CCC-SLP
• Suzanne Michelle Laird-Attum, APRN
• Azadeh Lakani
• Brittany Lake
• Kimberley Dawn Lakes, PHD
• Pravina Leah Lal, LCSW
• Sharleen Lal
• Jennie-Ann Lalanne

• Dentist in Irvine, CA
• Providers in Irvine, CA by specialty
• Dentist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2015; 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.