1. Home
  2. Directory
  3. Ohio
  4. Eastlake
  5. Clinic Center
  6. NPI Profile
Newly Listed Provider — this NPI profile has been added to the NPI registry within the last 90 days.

EASTLAKE OH DENTIST LLC
NPI 1124942008
Clinic/Center - Dental in Eastlake, OH

Active since August 05, 2026
34051 VINE ST, EASTLAKE, OH 44095(651) 444-9644 Get Directions Write a Review

NPPES record added: August 5, 2026. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Eastlake Oh Dentist Llc NPPES

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

EASTLAKE OH DENTIST LLC (NPI 1124942008) is a healthcare organization registered as a dental in Eastlake, Ohio and active in the NPI registry since August 2026. The organization lists David Park, President/ceo, as its authorized official.

NPPES Registry Identity

NPI1124942008
Entity TypeOrganization
Primary Taxonomy261QD0000X
Legal Business NameEASTLAKE OH DENTIST LLC
Location Address34051 VINE STEastlake, OH 44095-5107
Mailing Address34051 Vine StEastlake, OH 44095-5107
Phone(651) 444-9644
Organization SubpartNo
Authorized OfficialDavid ParkPresident/ceo · (443) 759-0910
Enumeration DateAugust 5, 2026
NPPES CertifiedAugust 5, 2026
✔ NPI 1124942008 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · DentalAmbulatory Health Care Facilities
Taxonomy Code261QD0000X
34051 VINE ST, Eastlake, OH 44095
Open in Google Maps ↗

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 Eastlake Oh Dentist LLC's NPI number?

The NPI number for Eastlake Oh Dentist LLC is 1124942008. It was assigned to this organization in the NPPES registry on August 5, 2026.

Where is Eastlake Oh Dentist LLC located?

Eastlake Oh Dentist LLC is located at 34051 Vine St, Eastlake, OH 44095. The listed phone number is (651) 444-9644.

What is Eastlake Oh Dentist LLC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Dental, with taxonomy code 261QD0000X.

When was this NPI record last updated?

The NPPES record for Eastlake Oh Dentist LLC was last updated on August 5, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 days 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.