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LAKE ROAD DENTAL LLC
NPI 1174016737
Clinic/Center - Dental in Dillingham, AK

Active since June 08, 2018
4622 SHANNON LAKE RD, DILLINGHAM, AK 99576(907) 842-2324 Get Directions Write a Review

NPPES record last updated: June 8, 2018. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Lake Road Dental Llc NPPES

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

LAKE ROAD DENTAL LLC (NPI 1174016737) is a healthcare organization registered as a dental in Dillingham, Alaska and active in the NPI registry since June 2018. The organization lists Kelly Lucas, Dentist/ Owner, as its authorized official.

NPPES Registry Identity

NPI1174016737
Entity TypeOrganization
Primary Taxonomy261QD0000X
Legal Business NameLAKE ROAD DENTAL LLC
Location Address4622 SHANNON LAKE RDDillingham, AK 99576
Mailing AddressPo Box 969Dillingham, AK 99576-0969 · (907) 842-2324
Phone(907) 842-2324
Organization SubpartNo
Authorized OfficialKelly LucasDentist/ Owner · (907) 842-2324
Enumeration DateJune 8, 2018
✔ NPI 1174016737 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · DentalAmbulatory Health Care Facilities
Taxonomy Code261QD0000X
4622 SHANNON LAKE RD, Dillingham, AK 99576
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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 Road Dental LLC's NPI number?

The NPI number for Lake Road Dental LLC is 1174016737. It was assigned to this organization in the NPPES registry on June 8, 2018.

Where is Lake Road Dental LLC located?

Lake Road Dental LLC is located at 4622 Shannon Lake Rd, Dillingham, AK 99576. The listed phone number is (907) 842-2324.

What is Lake Road Dental 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 Lake Road Dental LLC was last updated on June 8, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 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.