Lakecrest Dental-Owasso 96TH

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

LAKECREST DENTAL-OWASSO 96TH

Practice address

9551 N. Owasso Expressway
Suite #100
Owasso, OK 74055

Phone

(918) 376-6165

Fax

(918) 376-6160

NPI assigned

Aug 27, 2019

Last updated

Oct 29, 2019By 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

Michelle Mayre Moss

Title

Office Manager

Phone

(918) 376-6165

Specialties & licenses 1

Addresses

Other names 1

• Lakecrest Owasso Other name

Tax ID family

L a Investments2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• L & a Investments

  dba Smile Again Dental Care

  • Dental Clinic/Center
  • Sand Springs, OK
  • NPI 1760857742
  NPD tax ID

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

{
    "created_epoch": "1566864000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1572307200000",
    "number": "1972151587",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9551 N. OWASSO EXPY SUITE 100",
            "city": "OWASSO",
            "state": "OK",
            "postal_code": "74055",
            "telephone_number": "918-376-6165",
            "fax_number": "918-376-6160"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9551 N. OWASSO EXPRESSWAY",
            "address_2": "SUITE #100",
            "city": "OWASSO",
            "state": "OK",
            "postal_code": "74055",
            "telephone_number": "918-376-6165",
            "fax_number": "918-376-6160"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKECREST DENTAL-OWASSO 96TH",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-08-27",
        "last_updated": "2019-10-29",
        "status": "A",
        "authorized_official_last_name": "MOSS",
        "authorized_official_first_name": "MICHELLE",
        "authorized_official_middle_name": "MAYRE",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "918-376-6165"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lakecrest Owasso",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Lakecrest Owasso",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Noah Krohner, PSY.D.
• Taylore Dawn Kusel, APRN
• Nathan Eric Kuykendall, OD
• Paul J. Labreche Jr., D.C., P.T.
• Alyssa Lacey
• Ruchira Lalwani, DDS
• Kendall Lamb, MS
• Wanjiru Landers
• Jake Wesley Landreth, DC
• Meagan Lane, COTA

• General Practice Dentistry in Owasso, OK
• Providers in Owasso, OK by specialty
• General Practice Dentistry in Oklahoma

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