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LAKE STREET FAMILY DENTAL PA
NPI 1083096085
Dentist in Mora, MN

Active since June 25, 2015
119 LAKE ST S, SUITE 1, MORA, MN 55051(320) 679-2435 Get Directions Write a Review

NPPES record last updated: June 25, 2015. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Lake Street Family Dental Pa NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

LAKE STREET FAMILY DENTAL PA (NPI 1083096085) is a healthcare organization registered as a dentist in Mora, Minnesota and active in the NPI registry since June 2015. The organization lists Steven Nelson Holcombe, President, as its authorized official.

NPPES Registry Identity

NPI1083096085
Entity TypeOrganization
Primary Taxonomy122300000X
Legal Business NameLAKE STREET FAMILY DENTAL PA
Location Address119 LAKE ST S, SUITE 1Mora, MN 55051-1576
Mailing Address10799 251st Ave NwZimmerman, MN 55398-4558 · (763) 350-6234
Phone(320) 679-2435
Organization SubpartNo
Authorized OfficialSteven Nelson HolcombePresident · (763) 350-6234
Enumeration DateJune 25, 2015
✔ NPI 1083096085 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentistDental Providers
Taxonomy Code122300000X
License✔ Licensed in MN · D13567
Definition
A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist.
119 LAKE ST S, Mora, MN 55051
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include UnitedHealthcare.Insurance ›

Other Providers at the Same Location NPPES 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. STEVEN NELSON HOLCOMBE DMD
Dentist
119 LAKE ST S, SUITE 1
MORA, MN 55051
Kanabec County (320) 679-2435
MR. JASON NORDBY CMT
Massage Therapist
119 LAKE ST S
MORA, MN 55051
Kanabec County (651) 464-4701
DR. JAMES KNUTSON
Dentist
119 LAKE ST S, SUITE 1
MORA, MN 55051
Kanabec County (320) 679-2435

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Lake Street Family Dental PA's NPI number?

The NPI number for Lake Street Family Dental PA is 1083096085. It was assigned to this organization in the NPPES registry on June 25, 2015.

Where is Lake Street Family Dental PA located?

Lake Street Family Dental PA is located at 119 Lake St S Suite 1, Mora, MN 55051. The listed phone number is (320) 679-2435.

What is Lake Street Family Dental PA's specialty?

The primary specialty registered for this NPI is Dentist with taxonomy code 122300000X.

What insurance does Lake Street Family Dental PA accept?

Health plans from UnitedHealthcare list Lake Street Family Dental PA as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Lake Street Family Dental PA was last updated on June 25, 2015. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.