Individual provider Active NPI

Samuel Scott Lachance, D.D.S.

  • General Practice Dentistry
  • Minneapolis, MN
National Provider Identifier
1972708816
Registry record updated May 17, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
D12398 Issued in MN
Practice address
2309 Lyndale Ave S
Minneapolis, MN 55405-3661
Phone
(612) 424-6850
NPI assigned
Jun 20, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 17, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X D12398 MN Primary

Addresses

Primary practice location

2309 Lyndale Ave S
Minneapolis, MN 55405-3661

Mailing address

2309 Lyndale Ave S
Minneapolis, MN 55405-3661
Phone (612) 424-6850

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
D12398MNMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Associated Dentists General Practice Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1182297600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1558051200000",
    "number": "1972708816",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2309 LYNDALE AVE S",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554053661",
            "telephone_number": "612-424-6850"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2309 LYNDALE AVE S",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554053661",
            "telephone_number": "612-424-6850"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LACHANCE",
        "first_name": "SAMUEL",
        "middle_name": "SCOTT",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-20",
        "last_updated": "2019-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MN",
            "license": "D12398",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 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.