NPIMap

Organization Active NPI

Lakeville Dental Associates, P.a.

  • Dental Clinic/Center
  • Lakeville, MN
National Provider Identifier
1871697805
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
Legal business name
LAKEVILLE DENTAL ASSOCIATES, P.A.
Practice address
20171 Icenic TRL
Lakeville, MN 55044-7708
Phone
(952) 469-3300
NPI assigned
Sep 11, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. John L Harrison, DDSNPI 1629142070
Title
Dentist
Phone
(952) 469-3300

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
Dental Clinic/Center 261QD0000X Primary

Addresses

Primary practice location

20171 Icenic TRL
Lakeville, MN 55044-7708

Mailing address

20171 Icenic TRL
Lakeville, MN 55044-7708
Phone (952) 469-3300

National Provider Directory

National Provider Directory

Locations

20171 Icenic Trl
Lakeville, MN 55044
Phone (952) 469-3300

Practitioners & affiliated clinicians

Practitioners 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1157932800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1871697805",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20171 ICENIC TRL",
            "city": "LAKEVILLE",
            "state": "MN",
            "postal_code": "550447708",
            "telephone_number": "952-469-3300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20171 ICENIC TRL",
            "city": "LAKEVILLE",
            "state": "MN",
            "postal_code": "550447708",
            "telephone_number": "952-469-3300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKEVILLE DENTAL ASSOCIATES, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-11",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "HARRISON",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "952-469-3300",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakeville, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.