LAKESIDE FAMILY DENTISTRY (NPI# 1982198719) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1982198719 |
| Entity Type | Organization |
| Organization Name | LAKESIDE FAMILY DENTISTRY |
| Practice Address |
3173 Ne West Devils Lake Rd. Lincoln City OR 97367 |
| Practice Telephone | 5419948135 |
| Practice Fax Number | 5419948136 |
| Mailing Telephone | 5419948135 |
| Mailing Fax Number | 5419948136 |
| Enumeration Date | 2018-06-15 |
| Last Update Date | 2018-06-15 |
| Authorized Official Name | JAMES A RANSOM (OWNER/DENTIST) |
| Authorized Official Telephone | 5419948135 |
| Authorized Official Credential | DDS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
8192 | OR | Dental Providers |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Oregon Corporations, Companies and Business Names | LAKESIDE FAMILY DENTISTRY, LLC | 3173 W Devils Lake Rd, Lincoln City, OR 97367 |
| Indiana Business Entities | LAKESIDE FAMILY DENTISTRY, LLC | 935 N Detroit Street, Warsaw, IN 46580 |
| Street Address |
3173 NE WEST DEVILS LAKE RD. |
| City | LINCOLN CITY |
| State | OR |
| Zip Code | 97367 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881256121 | Amanda Suzanne Cherryholmes | Peer Specialist | 1206 Se 48th Place, Montgomery, Lincoln City, OR 97367 | 2019-07-08 |
| 1891282117 | Mark J Lee | Marriage & Family Therapist | 412 Southwest Highway 101, Lincoln City, OR 97367 | 2018-04-23 |
| 1508130196 | Michelle Marie Becker | Pharmacist | 1030 Se Oar Ave Bi-mart, Lincoln City, OR 97367 | 2012-02-29 |
| 1457651465 | Laurene Norelle Alcocer | Pharmacist | 4048 Ne Hwy 101, Lincoln City, OR 97367 | 2010-10-25 |
| 1518106228 | Estate of Kevin L. Chancellor | Dentist | 3173 Ne West Devils Lake Rd, Lincoln City, OR 97367 | 2009-02-19 |
| 1346403656 | Lincoln City Pharmacy & Gifts | Pharmacy | 1800 Se Hwy 101, Suite C, Lincoln City, OR 97367 | 2008-07-07 |
| 1841487139 | Assisted Living Concepts Inc | Assisted Living Facility | 1400 Se 19th, Lincoln City, OR 97367 | 2007-10-01 |
| 1376741074 | Frank Wesley Nettleship | Dentist | 9101 Keys Place, Lincoln City, OR 97367 | 2007-07-05 |
| 1306043989 | Julie Anne Bass | Case Manager/Care Coordinator | 4402 Devils Lake Blvd #2, Lincoln City, OR 97367 | 2007-06-28 |
| 1174745202 | Dorchester House Retirement Residence LLC | Assisted Living Facility | 2701 Hwy 101, Lincoln City, OR 97367 | 2007-05-02 |
| Find all providers in zip 97367 | ||||
| Taxonomy Code | 1223G0001X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | General Practice |
| A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. |
| Notes: Source: Academy of General Dentistry |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154774677 | Crisdental Lincoln City, LLC | Dentist | 2604 Ne Highway 101, Lincoln City, OR 97367-4460 | 2016-07-20 |
| 1518106228 | Estate of Kevin L. Chancellor | Dentist | 3173 Ne West Devils Lake Rd, Lincoln City, OR 97367 | 2009-02-19 |
| 1225178700 | Paul M. Jensen | Dentist | 1120 Se 1st St, Lincoln City, OR 97367-2803 | 2007-02-07 |
| 1790138642 | Crystal Kelso | Dentist | 1105 Se Jetty Ave, #b, Lincoln City, OR 97367-2632 | 2016-07-15 |
| 1639360365 | Dewayne C Bowman | Dentist | 2825 Ne W Devils Lk Rd, Lincoln City, OR 97367-5128 | 2007-08-07 |
| 1124110036 | James L. Garrett | Dentist | 1105 Se Jetty Ave, B, Lincoln City, OR 97367-2632 | 2006-09-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700486438 | Jane Jeeyoon Kim | Dentist | 14425 Sw Allen Blvd # 1, Beaverton, OR 97005-4402 | 2020-10-30 |
| 1780283556 | Ziyad Amir Kadir | Dentist | 300 Tatone St, Boardman, OR 97818-7900 | 2020-10-22 |
| 1295333912 | John Andrew Fawcett | Dentist | 214 Jersey St, Silverton, OR 97381-1627 | 2020-10-14 |
| 1629685920 | Alexandroff Dmd PC | Dentist | 1085 E Harbor Drive, Warrenton, OR 97146 | 2020-09-30 |
| 1760097034 | Hannah Glazunov | Dentist | 4970 S Landing Dr Unit 302, Portland, OR 97239-5900 | 2020-09-13 |
| 1235742198 | Geoffrey Houf | Dentist | 5880 Ne Cornell Rd Ste D, Hillsboro, OR 97124-9075 | 2020-08-28 |
| 1124631650 | Sugandha Gupta | Dentist | 2561 Nw 167th Ave, Beaverton, OR 97006-7643 | 2020-08-25 |
| 1609489137 | Open Door Dental Group PC | Dentist | 1710 E Pine St Ste A, Central Point, OR 97502-2811 | 2020-08-25 |
| 1720698566 | Travis Alcorn | Dentist | 2750 Kingwood St, Florence, OR 97439-9556 | 2020-08-06 |
| 1811506322 | Ruiwei Liang | Dentist | 547 Se 73rd Ave, Hillsboro, OR 97123-6199 | 2020-07-30 |
| Find all providers with the same taxonomy | ||||
| City | LINCOLN CITY |
| Zip Code | 97367 |
Please comment or provide details below to improve the information on LAKESIDE FAMILY DENTISTRY.
| 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.