LAKE CITY DENTAL CLINIC – NPI #1376143081
Clinic/Center

LAKE CITY DENTAL CLINIC is an AHC clinic located in LAKE CITY, CO. NPPES has assigned the NPI number 1376143081 to LAKE CITY DENTAL CLINIC on October 30, 2020. It is a Type-2 NPI, indicating this NPI number is associated with an organization. The primary taxonomy selected by this provider is 261QD0000X from the Health Care Provider Taxonomy code set, which is classified as Clinic/Center, specializing in Dental

Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for LAKE CITY DENTAL CLINIC below.

NPI Profile for
LAKE CITY DENTAL CLINIC

NPI Number
1376143081
Enumeration Date

(more than 5 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
LAKE CITY DENTAL CLINIC
Primary location
700 N HENSON ST
LAKE CITY, CO 81235-5134
Phone: (970) 944-2331 Fax: (970) 944-2320
Mailing address
PO BOX 999
LAKE CITY, CO 81235-0999
Phone: (970) 944-2331 Fax: (970) 944-2320
Organization Subpart
No
Authorized Official
JESSICA WHIDDON
EXECUTIVE DIRECTOR
Phone: (970) 944-2331
Updated
Certification Date
Oct 28, 2020

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

Identifiers

Identifiers for LAKE CITY DENTAL CLINIC

Identifiers are used to associate other provider identifiers such as Medicaid or other insurers (ie:, Blue Cross, Blue Shield, Aetna, Kaiser-Permanente, etc.), with their NPI number. These identifiers can be used in matching an NPI number to an insurer's records. However, not all providers have such numbers and not all providers choose to include them in their NPI information.

DescriptionIssuerStateIdentifier
MEDICAIDCO9000141620
Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
261QD0000X
- Clinic/Center / Dental (Primary)

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.