NPIMap

Organization Active NPI

Lakeside Smiles, LLC

  • General Practice Dentistry
  • Columbia, MD
National Provider Identifier
1841750965
Registry record updated Oct 16, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
LAKESIDE SMILES, LLC
Practice address
7135 Minstrel Way Ste 101
Columbia, MD 21045-5293
Phone
(443) 832-3305
NPI assigned
Mar 24, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 16, 2019

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

Authorized official

Name
Kathy Dipasquale Kim, DDSNPI 1609209477
Title
Owner, Dentist
Phone
(443) 979-9155

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X Primary

Addresses

Primary practice location

7135 Minstrel Way Ste 101
Columbia, MD 21045-5293

Mailing address

11716 Pindell Chase Dr
Fulton, MD 20759-9704
Phone (703) 943-8360

National Provider Directory

National Provider Directory

Locations

7135 Minstrel Way
Ste 101
Columbia, MD 21045
Phone (410) 290-5688

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1553385600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1571184000000",
    "number": "1841750965",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11716 PINDELL CHASE DR",
            "city": "FULTON",
            "state": "MD",
            "postal_code": "207599704",
            "telephone_number": "703-943-8360"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7135 MINSTREL WAY STE 101",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "210455293",
            "telephone_number": "443-832-3305"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKESIDE SMILES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-03-24",
        "last_updated": "2019-10-16",
        "status": "A",
        "authorized_official_last_name": "KIM",
        "authorized_official_first_name": "KATHY",
        "authorized_official_middle_name": "DIPASQUALE",
        "authorized_official_title_or_position": "OWNER, DENTIST",
        "authorized_official_telephone_number": "443-979-9155",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2019; 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.