1. Home
  2. Directory
  3. New York
  4. Lakewood
  5. Dentist
  6. NPI Profile

LAKEWOOD PEDIATRIC DENTISTRY PLLC
NPI 1417499500
Dentist - Pediatric Dentistry in Lakewood, NY

Active since November 07, 2016
133 E FAIRMOUNT AVE STE 1, LAKEWOOD, NY 14750(716) 763-0130 Get Directions Write a Review

NPPES record last updated: November 7, 2016. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Lakewood Pediatric Dentistry Pllc NPPES

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

LAKEWOOD PEDIATRIC DENTISTRY PLLC (NPI 1417499500) is a healthcare organization registered as a pediatric dentistry in Lakewood, New York and active in the NPI registry since November 2016. The organization lists Jan Carlson, Owner/dentist, as its authorized official.

NPPES Registry Identity

NPI1417499500
Entity TypeOrganization
Primary Taxonomy1223P0221X
Legal Business NameLAKEWOOD PEDIATRIC DENTISTRY PLLC
Location Address133 E FAIRMOUNT AVE STE 1Lakewood, NY 14750-1950
Mailing Address133 E Fairmount Ave Ste 1Lakewood, NY 14750-1950 · (716) 763-0130
Phone(716) 763-0130
Organization SubpartNo
Authorized OfficialJan CarlsonOwner/dentist · (716) 763-0130
Enumeration DateNovember 7, 2016
✔ NPI 1417499500 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · Pediatric DentistryDental Providers
Taxonomy Code1223P0221X
License✔ Licensed in NY · 058246
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.
133 E FAIRMOUNT AVE STE 1, Lakewood, NY 14750
Open in Google Maps ↗

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. JAN RAY CARLSON DDS
Dentist (Pediatric Dentistry)
133 E FAIRMOUNT AVE STE 1
LAKEWOOD, NY 14750
Chautauqua County (716) 763-0130

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 Pediatric Dentistry PLLC's NPI number?

The NPI number for Lakewood Pediatric Dentistry PLLC is 1417499500. It was assigned to this organization in the NPPES registry on November 7, 2016.

Where is Lakewood Pediatric Dentistry PLLC located?

Lakewood Pediatric Dentistry PLLC is located at 133 E Fairmount Ave Ste 1, Lakewood, NY 14750. The listed phone number is (716) 763-0130.

What is Lakewood Pediatric Dentistry PLLC'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 Lakewood Pediatric Dentistry PLLC was last updated on November 7, 2016. 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.