LAKEWOOD CITY CENTER DENTAL LLC (NPI# 1710504592) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1710504592 |
| Entity Type | Organization |
| Organization Name | LAKEWOOD CITY CENTER DENTAL LLC |
| Practice Address |
14865 Detroit Ave Lakewood OH 44107-3909 |
| Practice Telephone | 2162287950 |
| Mailing Telephone | 2162287950 |
| Enumeration Date | 2020-06-29 |
| Last Update Date | 2020-06-29 |
| Authorized Official Name | CHARLYNE JUNGERMANN (PRACTICE MANAGER) |
| Authorized Official Telephone | 4408233175 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QD0000X |
Clinic/Center Specialization: Dental |
Ambulatory Health Care Facilities |
| Street Address |
14865 DETROIT AVE |
| City | LAKEWOOD |
| State | OH |
| Zip Code | 44107-3909 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740346634 | Rainard Michael Beer | Dentist | 14865 Detroit Ave, Lakewood, OH 44107-3909 | 2006-12-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326522210 | Lawrence M Roth | Social Worker | 14701 Detroit Ave Ste 363, Lakewood, OH 44107 | 2018-09-18 |
| 1376065730 | Fareeha Khan | Internal Medicine | 12540 Edgewater Drive, Apt 411, Lakewood, OH 44107 | 2017-07-07 |
| 1912433756 | Julie Ann Foucher-urcuyo | Family Medicine | 14601 Detroit Ave, Fl 2, Lakewood, OH 44107 | 2017-05-11 |
| 1225563661 | Elizabeth Ann Rainbolt | Family Medicine | 14601 Detroit Ave Fl 2, Lakewood, OH 44107 | 2017-04-24 |
| 1255882551 | Kristen Murray | Dietitian, Registered | 14900 Detroit Ave Ste 207, Lakewood, OH 44107 | 2016-10-21 |
| 1265828131 | David Thomas Jonke | Dentist | 15640 Madison Ave., Lakewood, OH 44107 | 2015-04-08 |
| 1760885941 | Debra Watkins | Home Health Aide | 1510 Newman Ave Apt 406, Lakewood, OH 44107 | 2014-10-02 |
| 1396155198 | Monica M Owen | Occupational Therapist | 9200 Biddulph Rd., Brooklyn, OH 44107 | 2014-05-01 |
| 1730512229 | Marsha Elaine Favors | Licensed Practical Nurse | 1448 Lakeland Ave, Lakewood, OH 44107 | 2013-08-20 |
| 1508130006 | Ruth Rachel Raciniewski | Counselor | 15200 Madison Avenue, Lakewood, OH 44107 | 2012-03-01 |
| Find all providers in zip 44107 | ||||
| Taxonomy Code | 261QD0000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Dental |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225510126 | N Ozder Dental Practice Inc | Clinic/Center | 5037 Lakewood Blvd, Lakewood, CA 90712 | 2018-09-06 |
| 1912415597 | Lakewood Kids and Adolescent Dentistry | Clinic/Center | 1776 Avenue of The States, Suite 105, Lakewood, NJ 08701 | 2018-01-17 |
| 1023525037 | Ten Family Dentistry | Clinic/Center | 3333 S Wadsworth Blvd Unit 303d, Lakewood, CO 80227-5142 | 2017-12-29 |
| 1013429778 | Grace E. Rudersdorf, Dds, Pllc | Clinic/Center | 11290 W Alameda Ave Ste A-100, Lakewood, CO 80226-2575 | 2017-11-02 |
| 1073034088 | Sage Dentistry V Pllc | Clinic/Center | 325 S Teller St Ste 208, Lakewood, CO 80226-7388 | 2017-06-29 |
| 1780065797 | Bear Dental Group Prof. LLC | Clinic/Center | 10815 W Jewell Ave, Suite L, Lakewood, CO 80232-4851 | 2015-06-16 |
| 1790163004 | Associated Dental Professionals | Clinic/Center | 8015 W Alameda Ave Ste 170, Lakewood, CO 80226-3042 | 2015-05-07 |
| 1043576242 | Kt Dental LLC | Clinic/Center | 95 S Sheridan Blvd, Suite C, Lakewood, CO 80226-2445 | 2012-04-02 |
| 1255597530 | Aesthetic Smile Dental Center | Clinic/Center | 3203 Carson St, Suite # 2, Lakewood, CA 90712-4006 | 2008-08-06 |
| 1558475616 | Bruce C Mcarthur, Dds, PC | Clinic/Center | 6565 W Jewell Ave Ste 9, Lakewood, CO 80232-7102 | 2006-08-18 |
| Find all providers in LAKEWOOD | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.