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LAKEWOOD FAMILY DENTAL INC
NPI 1386062768
Dentist in Fort Wayne, IN

Active since April 02, 2014
4512 PARNELL AVE, FORT WAYNE, IN 46825(732) 379-0953 Get Directions Write a Review

NPPES record last updated: April 3, 2014. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Lakewood Family Dental Inc NPPES

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

LAKEWOOD FAMILY DENTAL INC (NPI 1386062768) is a healthcare organization registered as a dentist in Fort Wayne, Indiana and active in the NPI registry since April 2014. The organization lists Srinivasulu Kakollu, President, as its authorized official.

NPPES Registry Identity

NPI1386062768
Entity TypeOrganization
Primary Taxonomy122300000X
Legal Business NameLAKEWOOD FAMILY DENTAL INC
Location Address4512 PARNELL AVEFort Wayne, IN 46825-5836
Mailing Address1407 N Veterans Pkwy, Suite 12Bloomington, IL 61704-6630 · (732) 379-0953
Phone(732) 379-0953
Organization SubpartNo
Authorized OfficialSrinivasulu KakolluPresident · (732) 379-0953
Enumeration DateApril 2, 2014
Last NPPES UpdateApril 3, 2014
✔ NPI 1386062768 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentistDental Providers
Taxonomy Code122300000X
License✔ Licensed in IL · 019028401
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.
4512 PARNELL AVE, Fort Wayne, IN 46825
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Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter from Meridian, Ambetter Health and more.Insurance ›

Other Providers at the Same Location NPPES 4

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

DR. SURESH KUMAR VARMA VEGESANA D.D.S.
Dentist
4512 PARNELL AVE
FORT WAYNE, IN 46825
Allen County (260) 399-1333
DR. VINIT ANIL AHER DDS
Dentist (General Practice)
4512 PARNELL AVE
FORT WAYNE, IN 46825
Allen County (260) 238-8899
YAGNA ROOPA KASARANENI
Dentist (General Practice)
4512 PARNELL AVE
FORT WAYNE, IN 46825
Allen County (260) 238-8899
MANSIMRAN SANDHU
Dentist
4512 PARNELL AVE
FORT WAYNE, IN 46825
Allen County (260) 238-8899

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 Lakewood Family Dental Inc's NPI number?

The NPI number for Lakewood Family Dental Inc is 1386062768. It was assigned to this organization in the NPPES registry on April 2, 2014.

Where is Lakewood Family Dental Inc located?

Lakewood Family Dental Inc is located at 4512 Parnell Ave, Fort Wayne, IN 46825. The listed phone number is (732) 379-0953.

What is Lakewood Family Dental Inc's specialty?

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

What insurance does Lakewood Family Dental Inc accept?

Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Meridian, DentaQuest USA Insurance and UnitedHealthcare list Lakewood Family Dental Inc 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 Lakewood Family Dental Inc was last updated on April 3, 2014. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 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.