Lakeview Dental Studio

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

LAKEVIEW DENTAL STUDIO

Practice address

5315 Fountain Rd
Knoxville, TN 37918-3094

Phone

(865) 687-6763

NPI assigned

May 21, 2024

Organization subpart

No

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

Authorized official

Name

Dr. Tylen Haderlie, DDSNPI 1558711010

Title

Owner

Phone

(816) 646-1057

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.

• Tylen K Haderlie, DDS

  • Dentist
  • Knoxville, TN
  • NPI 1558711010
  NPD Authorized official

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

{
    "created_epoch": "1716249600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1716249600000",
    "number": "1871332841",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5315 FOUNTAIN RD",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379183094",
            "telephone_number": "865-687-6763"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5315 FOUNTAIN RD",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379183094",
            "telephone_number": "865-687-6763"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKEVIEW DENTAL STUDIO",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-05-21",
        "last_updated": "2024-05-21",
        "certification_date": "2024-05-21",
        "status": "A",
        "authorized_official_last_name": "HADERLIE",
        "authorized_official_first_name": "TYLEN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "816-646-1057",
        "authorized_official_name_prefix": "Dr.",
        "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": []
}

• Lindsey Nicole Lakas, DNP
• Timothy Edward Lakas, RN
• Donald Andrew Lakatosh, M.D.
• Corey Lake
• Lakeshore Health and Rehabilitation Center LLC
• Rebecca Gail Lakey, RN
• Beverly Alexandra Lakin
• Paul Gary Lakins
• Ameeta Lall, M.D.
• Lauren Lally, CCC-SLP

• General Practice Dentistry in Knoxville, TN
• Providers in Knoxville, TN by specialty
• General Practice Dentistry in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 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.