LAKESIDE DENTAL LLC


Address: 1051 Western Ave, Manchester, ME 04351-3403
Phone: 2073100842

LAKESIDE DENTAL LLC (NPI# 1891262804) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1891262804
Entity Type Organization
Organization Name LAKESIDE DENTAL LLC
Practice Address 1051 Western Ave
Manchester
ME 04351-3403
Mailing Address 60 Willow Ln
Portland
ME 04102-2629
Practice Telephone 2073100842
Mailing Telephone 2073100842
Enumeration Date 2018-10-29
Last Update Date 2018-10-29
Authorized Official Name DR. RYAN SALAMON (MANAGER)
Authorized Official Telephone 2073100842
Authorized Official Credential DMD
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 261QD0000X Clinic/Center
Specialization: Dental
Ambulatory Health Care Facilities

Other Provider IDs and Locations

NPI Name Taxonomy Address Enumeration
1003268608 Lakeside Dental LLC Dentist 15775 Highway 16 E, Shirley, AR 72153-8930 2016-07-07
1518317858 Lakeside Dental LLC Dentist 5600 W Brown Deer Rd, Suite 111, Milwaukee, WI 53223-2311 2016-06-17

Other Data Sources

Entity Type Entity Name Entity Address
Washington State Corporations LAKESIDE DENTAL LLC 15720 68th Ave W, Edmonds, WA 98026-4509

Office Location

Street Address 1051 WESTERN AVE
City MANCHESTER
State ME
Zip Code 04351-3403

Providers in the same location

NPI Name Taxonomy Address Enumeration
1609896646 James B. Newton Dentist 1051 Western Ave, Manchester, ME 04351-0450 2006-07-20

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1497171318 Peter J Volk Family Medicine 23 Bowdoin Street, Manchester, ME 04351 2014-03-17
1740563428 Insight-premier Health LLC Clinic/Center 27 Bowdoin Street, Manchester, ME 04351 2011-09-20
1427353069 Robin Page Dufour Physical Therapist 6 Rockwood Dr, Suite 2, Manchester, ME 04351 2011-01-12
1174839708 Richard Ofoe Kavi Pharmacist 943 Western Ave, Manchester, ME 04351 2010-08-20
1700199031 Neil A Graves Pharmacist 943 Western Ave., Manchester, ME 04351 2010-07-15
1427212059 Dustin R Sulak Family Medicine 964 Western Ave., Manchester, ME 04351 2008-07-14
1437312295 Crossroads Counseling Center Pllc Social Worker 726 Western Ave., Manchester, ME 04351 2008-07-02
1548453616 Christopher Paul Beaudoin Social Worker 15 Range Way Suite 3, Manchester, ME 04351 2007-08-22
1275724288 Shawn Kenneth Hodgdon Social Worker 726 Western Avenue, Manchester, ME 04351 2007-08-05
1790900512 Scott A Hayward Social Worker 15 Range Way, Suite 3, Manchester, ME 04351 2007-04-16
Find all providers in zip 04351

Taxonomy Information

Taxonomy Code 261QD0000X
Grouping Ambulatory Health Care Facilities
Classification Clinic/Center
Specialization Dental

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1780006759 Gentle Dental Associates, LLC Clinic/Center 801 Elm St, Manchester, NH 03101-2103 2014-01-10
1972147866 Sunshine Dental of Manchester Clinic/Center 168 Spencer St, Manchester, CT 06040-4616 2019-11-04
1265073563 North End Dental Care Pllc Clinic/Center 1361 Elm St Ste 202, Manchester, NH 03101-1323 2019-10-08
1447715602 42 North Dental Clinic/Center 238 Tolland Tpke, Manchester, CT 06042-1744 2019-02-01
1659858801 Manchester Dental Surgery and Implant Center Clinic/Center 30 Canton St Ste 12, Manchester, NH 03103-3524 2018-07-20
1467960880 Robert C. Fromuth Dds Pllc Clinic/Center 765 S Main St Ste 102, Manchester, NH 03102-5141 2018-01-19
1356854426 Dr Dental of Manchester PC Clinic/Center 460 Elm St, Manchester, NH 03101-2701 2017-11-13
1760905830 Bh Dental LLC Clinic/Center 194 Buckland Hills Dr Ste 1076, Manchester, CT 06042-8785 2017-07-20
1104205707 Amoskeag Family Dentistry, LLP Clinic/Center 316 S Main St, Manchester, NH 03102-4842 2015-05-28
1548649890 Audc Dental Group Pllc Clinic/Center 324 S Main St, Manchester, NH 03102-4842 2015-05-20
Find all providers in MANCHESTER

Competitor

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City MANCHESTER
Zip Code 04351

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Dataset Information

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.

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