NPIMap

Organization Active NPI

Lakebrink Dental

  • General Practice Dentistry
  • Liberty, MO
National Provider Identifier
1942557368
Registry record updated Aug 6, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
14423 Issued in MO
Legal business name
LAKEBRINK DENTAL
Practice address
105 N Stewart CT
Suite 140
Liberty, MO 64068-1066
Phone
(816) 792-4455
NPI assigned
Aug 6, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 6, 2012

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

Authorized official

Name
Dr. Thomas G Lakebrink, DDSNPI 1073593976
Title
Owner/Dentist
Phone
(816) 792-4455

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223G0001X 14423 MO Primary
General Practice DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223G0001X 2011014525 MO

Addresses

Primary practice location

105 N Stewart CT
Suite 140
Liberty, MO 64068-1066

Mailing address

105 N Stewart CT
Suite 140
Liberty, MO 64068-1066
Phone (816) 792-4455

National Provider Directory

National Provider Directory

Locations

105 N Stewart Ct
Ste 140
Liberty, MO 64068
Phone (816) 792-4455

Practitioners & affiliated clinicians

Practitioners 3

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": "1344211200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1344211200000",
    "number": "1942557368",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 N STEWART CT",
            "address_2": "SUITE 140",
            "city": "LIBERTY",
            "state": "MO",
            "postal_code": "640681066",
            "telephone_number": "816-792-4455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 N STEWART CT",
            "address_2": "SUITE 140",
            "city": "LIBERTY",
            "state": "MO",
            "postal_code": "640681066",
            "telephone_number": "816-792-4455"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKEBRINK DENTAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-08-06",
        "last_updated": "2012-08-06",
        "status": "A",
        "authorized_official_last_name": "LAKEBRINK",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "OWNER/DENTIST",
        "authorized_official_telephone_number": "816-792-4455",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "MO",
            "license": "14423",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "MO",
            "license": "2011014525",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Liberty, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2012; 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.