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LAKE HARBOR DENTAL PLLC
NPI 1427669720
Clinic/Center - Dental in Boise, ID

Active since August 11, 2020
5355 W STATE ST, BOISE, ID 83703(208) 853-4687 Get Directions Write a Review

NPPES record last updated: August 11, 2020. Verified against the NPPES registry weekly; last sync: September 13, 2026.

About Lake Harbor Dental Pllc NPPES

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

LAKE HARBOR DENTAL PLLC (NPI 1427669720) is a healthcare organization registered as a dental in Boise, Idaho and active in the NPI registry since August 2020. The organization lists Eric Ballou, Owner, as its authorized official.

NPPES Registry Identity

NPI1427669720
Entity TypeOrganization
Primary Taxonomy261QD0000X
Legal Business NameLAKE HARBOR DENTAL PLLC
Location Address5355 W STATE STBoise, ID 83703-3333
Mailing Address5355 W State StBoise, ID 83703-3333 · (208) 853-4687
Phone(208) 853-4687
Organization SubpartNo
Authorized OfficialEric BallouOwner · (208) 853-4687
Enumeration DateAugust 11, 2020
NPPES CertifiedAugust 11, 2020
✔ NPI 1427669720 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · DentalAmbulatory Health Care Facilities
Taxonomy Code261QD0000X
5355 W STATE ST, Boise, ID 83703
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Other Providers at the Same Location NPPES 5

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

DR. STEPHEN PATRICK WHITE D.D.S
Dentist (General Practice)
5355 W STATE ST
BOISE, ID 83703
Ada County (208) 853-4687
LAKE HARBOR DENTAL
Dentist (General Practice)
5355 W STATE ST
BOISE, ID 83703
Ada County (208) 853-4687
WHITE SMILES LLC
Dentist (General Practice)
5355 W STATE ST
BOISE, ID 83703
Ada County (208) 853-4687
MICHAEL E PETERSON DDS
Dentist
5355 W STATE ST
BOISE, ID 83703
Ada County (208) 853-4687
ERIC BALLOU DDS
Dentist
5355 W STATE ST
BOISE, ID 83703
Ada County (208) 853-4687

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 Harbor Dental PLLC's NPI number?

The NPI number for Lake Harbor Dental PLLC is 1427669720. It was assigned to this organization in the NPPES registry on August 11, 2020.

Where is Lake Harbor Dental PLLC located?

Lake Harbor Dental PLLC is located at 5355 W State St, Boise, ID 83703. The listed phone number is (208) 853-4687.

What is Lake Harbor Dental PLLC'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 Harbor Dental PLLC was last updated on August 11, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.