Lakeside Dental LLC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

LAKESIDE DENTAL LLC

Practice address

1051 Western Ave
Manchester, ME 04351-3403

Phone

(207) 310-0842

NPI assigned

Oct 29, 2018

Last updated

Oct 29, 2018By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Ryan Salamon, DMDNPI 1538651054

Title

Manager

Phone

(207) 310-0842

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, and the practitioner matching its NPPES authorized official.

• Ryan Salamon, DMD

  • General Practice Dentistry
  • Portland, ME
  • NPI 1538651054
  NPD (past) Authorized official

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

{
    "created_epoch": "1540771200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1540771200000",
    "number": "1891262804",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "60 WILLOW LN",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041022629",
            "telephone_number": "207-310-0842"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1051 WESTERN AVE",
            "city": "MANCHESTER",
            "state": "ME",
            "postal_code": "043513403",
            "telephone_number": "207-310-0842"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKESIDE DENTAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-10-29",
        "last_updated": "2018-10-29",
        "status": "A",
        "authorized_official_last_name": "SALAMON",
        "authorized_official_first_name": "RYAN",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "207-310-0842",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kidspeace National Centers of New England Inc
• Kidspeace National Centers of New England Inc
• Kidspeace National Centers of New England Inc
• Kidspeace National Centers of New England Inc
• Christopher Curtis King, APRN-FNP
• Steven T Leclair, AGACNP-BC
• Manchester Dental Associates (Central Maine Dentistry)
• Manchester Interventional Spine, LLC
• Adonna Maria Manzo, LCPC CONDITIONAL
• Christopher McInnis, BCBA

• Dental Clinic/Center in Manchester, ME
• Providers in Manchester, ME by specialty
• Dental Clinic/Center in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2018; 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.