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MOORE LAKE DENTAL
NPI 1386035590
Dentist in Fridley, MN

Active since February 10, 2015
6230 HIGHWAY 65 NE, SUITE 105, FRIDLEY, MN 55432(763) 571-5497 Get Directions Write a Review

NPPES record last updated: February 10, 2015. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Moore Lake Dental NPPES

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

MOORE LAKE DENTAL (NPI 1386035590) is a healthcare organization registered as a dentist in Fridley, Minnesota and active in the NPI registry since February 2015. The organization lists Lisa Murray Perez, Owner, as its authorized official.

NPPES Registry Identity

NPI1386035590
Entity TypeOrganization
Primary Taxonomy122300000X
Legal Business NameMOORE LAKE DENTAL
Location Address6230 HIGHWAY 65 NE, SUITE 105Fridley, MN 55432-5107
Mailing Address6230 Highway 65 Ne, Suite 105Fridley, MN 55432-5107 · (763) 571-5497
Phone(763) 571-5497
Organization SubpartNo
Authorized OfficialLisa Murray PerezOwner · (612) 414-2182
Enumeration DateFebruary 10, 2015
✔ NPI 1386035590 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentistDental Providers
Taxonomy Code122300000X
License✔ Licensed in MN · D10520
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.
6230 HIGHWAY 65 NE, Fridley, MN 55432
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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

Other Providers at the Same Location NPPES

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

DR. LISA MURRAY D.D.S.
Dentist (General Practice)
6230 HIGHWAY 65 NE, #105
FRIDLEY, MN 55432
Anoka County (763) 571-5497

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 Moore Lake Dental's NPI number?

The NPI number for Moore Lake Dental is 1386035590. It was assigned to this organization in the NPPES registry on February 10, 2015.

Where is Moore Lake Dental located?

Moore Lake Dental is located at 6230 Highway 65 NE Suite 105, Fridley, MN 55432. The listed phone number is (763) 571-5497.

What is Moore Lake Dental's specialty?

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

When was this NPI record last updated?

The NPPES record for Moore Lake Dental was last updated on February 10, 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.