Stephanie Drake, D.D.S.

Primary specialty

DentistTaxonomy code 122300000X

License

D13701 Issued in MN

Practice address

1880 W Wayzata Blvd
Long Lake, MN 55356-9491

Phone

(952) 475-0989

NPI assigned

May 31, 2016

Last updated

Feb 4, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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

• Byron Rowell PA

  • Dental Clinic/Center
  • Grand Rapids, MN
  • NPI 1275797763
  NPD (past)
• Kreklow Dental

  • Dental Clinic/Center
  • Grand Rapids, MN
  • NPI 1104490689
  NPD (past)
• Water's Edge Dental

  dba Lakeside Family Dentistry

  • Dental Clinic/Center
  • Long Lake, MN
  • NPI 1790146587
  NPD (past)

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

{
    "created_epoch": "1464652800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612396800000",
    "number": "1992153928",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1880 W WAYZATA BLVD",
            "city": "LONG LAKE",
            "state": "MN",
            "postal_code": "553569491",
            "telephone_number": "952-475-0989",
            "fax_number": "218-326-9502"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1880 W WAYZATA BLVD",
            "city": "LONG LAKE",
            "state": "MN",
            "postal_code": "553569491",
            "telephone_number": "952-475-0989"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "510 NW 2nd Ave",
            "address_purpose": "LOCATION",
            "city": "Grand Rapids",
            "state": "MN",
            "postal_code": "557442627",
            "country_code": "US",
            "telephone_number": "218-326-1266",
            "fax_number": "218-326-9502",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DRAKE",
        "first_name": "STEPHANIE",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-05-31",
        "last_updated": "2021-02-04",
        "certification_date": "2021-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MN",
            "license": "D13701",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Chirocenter Inc.
• Chiropractic First (ChiropracticUSA)
• Kevin Connery, DC
• Riley Sean Cullinane, DC
• Douglas J McNaught D D S P a (Long Lake Dental)
• Alissa Huhn, PHARMD
• Jonathan Kodet, PHD,LP
• Nichole Hirsch Kuechle, HOLISTIC PRACTITIONE
• Lake Minnetonka Counseling
• Lakeside Counseling

• Dentist in Long Lake, MN
• Providers in Long Lake, MN by specialty
• Dentist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.