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LAKESIDE PEDIATRIC DENTISTRY, LLC
NPI 1174064539
Dentist - Pediatric Dentistry in Greensboro, GA

Active since March 17, 2017
1050 PARKSIDE CMNS, SUITE 103, GREENSBORO, GA 30642(706) 454-2222(706) 454-1234 Get Directions Write a Review

NPPES record last updated: March 17, 2017. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Lakeside Pediatric Dentistry, Llc NPPES

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

LAKESIDE PEDIATRIC DENTISTRY, LLC (NPI 1174064539) is a healthcare organization registered as a pediatric dentistry in Greensboro, Georgia and active in the NPI registry since March 2017. The organization lists Tina Locher, Office Manager, as its authorized official.

NPPES Registry Identity

NPI1174064539
Entity TypeOrganization
Primary Taxonomy1223P0221X
Legal Business NameLAKESIDE PEDIATRIC DENTISTRY, LLC
Location Address1050 PARKSIDE CMNS, SUITE 103Greensboro, GA 30642-4524
Mailing Address1050 Parkside Cmns, Suite 103Greensboro, GA 30642-4524 · (706) 454-2222 · Fax (706) 454-1234
Phone(706) 454-2222
Fax(706) 454-1234
Organization SubpartNo
Authorized OfficialTina LocherOffice Manager · (478) 743-0901
Enumeration DateMarch 17, 2017
✔ NPI 1174064539 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · Pediatric DentistryDental Providers
Taxonomy Code1223P0221X
License✔ Licensed in GA · DN012737
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.
1050 PARKSIDE CMNS, Greensboro, GA 30642
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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

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 Lakeside Pediatric Dentistry, LLC's NPI number?

The NPI number for Lakeside Pediatric Dentistry, LLC is 1174064539. It was assigned to this organization in the NPPES registry on March 17, 2017.

Where is Lakeside Pediatric Dentistry, LLC located?

Lakeside Pediatric Dentistry, LLC is located at 1050 Parkside Cmns Suite 103, Greensboro, GA 30642. The listed phone number is (706) 454-2222.

What is Lakeside Pediatric Dentistry, LLC's specialty?

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

When was this NPI record last updated?

The NPPES record for Lakeside Pediatric Dentistry, LLC was last updated on March 17, 2017. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 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.