Lakeville Modern Dentistry, PLLC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

LAKEVILLE MODERN DENTISTRY, PLLC

Practice address

17746 Kenwood TRL
Lakeville, MN 55044-9454

Phone

(920) 723-8420

NPI assigned

Feb 20, 2023

Organization subpart

No

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

Authorized official

Name

Dr. Eric M Bender, DMDNPI 1194394288

Title

President

Phone

(920) 723-8420

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Eric Michael Bender, DMD

  • General Practice Dentistry
  • Lakeville, MN
  • NPI 1194394288
  NPD Authorized official
• McKenzy M. Buermann, DDS

  • General Practice Dentistry
  • Lakeville, MN
  • NPI 1902730120
  NPD (past)
• Robert B. Miller, DDS

  • General Practice Dentistry
  • Lakeville, MN
  • NPI 1841365293
  NPD (past)

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

{
    "created_epoch": "1676851200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1682121600000",
    "number": "1992403919",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17746 KENWOOD TRL",
            "city": "LAKEVILLE",
            "state": "MN",
            "postal_code": "550449454",
            "telephone_number": "952-388-1778",
            "fax_number": "952-388-1763"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17746 KENWOOD TRL",
            "city": "LAKEVILLE",
            "state": "MN",
            "postal_code": "550449454",
            "telephone_number": "920-723-8420"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKEVILLE MODERN DENTISTRY, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-02-20",
        "last_updated": "2023-04-22",
        "certification_date": "2023-04-22",
        "status": "A",
        "authorized_official_last_name": "BENDER",
        "authorized_official_first_name": "ERIC",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "920-723-8420",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI TYPE I",
            "identifier": "1194394288",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lakeville Family Health Clinic, LTD
• Lakeville Family Therapy
• Lakeville Foot and Ankle Practice PLLC
• Lakeville Integrated Health Clinic Inc.
• Lakeville Integrative Medicine Clinic
• Lakeville Orthodontic Associates LLC
• Lakeville Relief Care
• Lakeville Snyder Drug
• Debra J Lakin, RPH
• Laura Jane Lambert, MA, LPCC

• Dental Clinic/Center in Lakeville, MN
• Providers in Lakeville, MN by specialty
• Dental Clinic/Center in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2023; 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.