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LAKESHORE PEDIATRIC DENTISTRY PLLC
NPI 1114586625
Dentist - Pediatric Dentistry in Peru, NY

Active since June 08, 2019
2993 MAIN ST STE 2, PERU, NY 12972(518) 282-5519 Get Directions Write a Review

NPPES record last updated: June 8, 2019. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About Lakeshore Pediatric Dentistry Pllc NPPES

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

LAKESHORE PEDIATRIC DENTISTRY PLLC (NPI 1114586625) is a healthcare organization registered as a pediatric dentistry in Peru, New York and active in the NPI registry since June 2019. The organization lists Colleen Marie Lacombe-senecal, Pediatric Dentist/owner, as its authorized official.

NPPES Registry Identity

NPI1114586625
Entity TypeOrganization
Primary Taxonomy1223P0221X
Legal Business NameLAKESHORE PEDIATRIC DENTISTRY PLLC
Location Address2993 MAIN ST STE 2Peru, NY 12972-2927
Mailing Address2993 Main St Ste 2Peru, NY 12972-2927 · (518) 282-5519
Phone(518) 282-5519
Organization SubpartNo
Authorized OfficialColleen Marie Lacombe-senecalPediatric Dentist/owner · (518) 578-5295
Enumeration DateJune 8, 2019
✔ NPI 1114586625 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · Pediatric DentistryDental Providers
Taxonomy Code1223P0221X
Definition

An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs.

2993 MAIN ST STE 2, Peru, NY 12972
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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 ›

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 Lakeshore Pediatric Dentistry PLLC's NPI number?

The NPI number for Lakeshore Pediatric Dentistry PLLC is 1114586625. It was assigned to this organization in the NPPES registry on June 8, 2019.

Where is Lakeshore Pediatric Dentistry PLLC located?

Lakeshore Pediatric Dentistry PLLC is located at 2993 Main St Ste 2, Peru, NY 12972. The listed phone number is (518) 282-5519.

What is Lakeshore Pediatric Dentistry PLLC's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Pediatric Dentistry, with taxonomy code 1223P0221X.

What insurance does Lakeshore Pediatric Dentistry PLLC accept?

Health plans from UnitedHealthcare list Lakeshore Pediatric Dentistry PLLC 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 Lakeshore Pediatric Dentistry PLLC was last updated on June 8, 2019. NPI Profile syncs with the weekly NPPES data releases published by CMS.