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LAKESIDE DENTAL ASSOCIATES PA NPI 1801968342


NPI Information

NPI: 1801968342
Provider Name: LAKESIDE DENTAL ASSOCIATES, PA
Classification: Dentist - 122300000X
Entity Type: Organization

CLIA Number: 24D1040587

Address:
5331 E SUPERIOR ST
DULUTH, MN
ZIP 55804
Phone: (218) 525-1958
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LAKESIDE DENTAL ASSOCIATES, PA is a dentist in Duluth, MN. The provider is a dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist. LAKESIDE DENTAL ASSOCIATES, PA NPI is 1801968342. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

5331 E SUPERIOR ST
DULUTH, MN
ZIP 55804-423
Phone: (218) 525-1958
Fax: (218) 525-9219

The provider's authorized official is Todd Hansen .
The authorized official title is President and has the following contact phone number (218) 525-1958.

The CLIA number assigned to this NPI record is 24D1040587 - assisted living facility with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 11/13/2006 and was last updated on 8/22/2020.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1122300000XDentistD11088MINNESOTAYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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