Organization · Type 2 NPI
Lake Street Dental
Prosthodontics · Minneapolis, MN
NPI number
1184829509
Active
Practice location
1508 E Lake St
Minneapolis, MN 55407-1720
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| General Practice Dentistry | 1223G0001X | D11889 (MN) |
| Periodontics | 1223P0300X | D11718 (MN) |
| Prosthodontics Primary | 1223P0700X | D12007 (MN) |
Prosthodontics: That branch of dentistry pertaining to the restoration and maintenance of oral functions, comfort, appearance and health of the patient by the restoration of natural teeth and/or the replacement of missing teeth and contiguous oral and maxillofacial tissues with artificial substitutes.
Another provider at this address
About NPI 1184829509
Lake Street Dental's National Provider Identifier is 1184829509, issued on Jun 16, 2007. The primary taxonomy on file is Prosthodontics (1223P0700X), and the practice location is in Minneapolis, MN. The record was last updated on Sep 11, 2025.