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CHICAGO LAKE DENTAL
NPI 1497936389
Dentist - General Practice in Minneapolis, MN

Active since November 19, 2007
2900 CHICAGO AVE, MINNEAPOLIS, MN 55407(612) 823-2080(612) 823-5777 Get Directions Write a Review

NPPES record last updated: November 19, 2007. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Chicago Lake Dental NPPES

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

CHICAGO LAKE DENTAL (NPI 1497936389) is a healthcare organization registered as a general practice in Minneapolis, Minnesota and active in the NPI registry since November 2007. The organization lists David William Johnson, Owner, as its authorized official.

NPPES Registry Identity

NPI1497936389
Entity TypeOrganization
Primary Taxonomy1223G0001X
Legal Business NameCHICAGO LAKE DENTAL
Location Address2900 CHICAGO AVEMinneapolis, MN 55407-1322
Mailing Address2900 Chicago AveMinneapolis, MN 55407-1322 · (612) 823-2080 · Fax (612) 823-5777
Phone(612) 823-2080
Fax(612) 823-5777
Organization SubpartNo
Authorized OfficialDavid William JohnsonOwner · (612) 823-2080
Enumeration DateNovember 19, 2007
✔ NPI 1497936389 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · General PracticeDental Providers
Taxonomy Code1223G0001X
License✔ Licensed in MN · D9512
Definition
A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.
2900 CHICAGO AVE, Minneapolis, MN 55407
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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 5

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

HANNAH RUTH KARTAK DT
Dental Therapist
2900 CHICAGO AVE
MINNEAPOLIS, MN 55407
Hennepin County (612) 823-2080
DR. JERRY JAMES CONROY DDS
Dentist (General Practice)
2900 CHICAGO AVE
MINNEAPOLIS, MN 55407
Hennepin County (612) 823-2080
NATALIE KOHNER
Dental Therapist
2900 CHICAGO AVE
MINNEAPOLIS, MN 55407
Hennepin County (612) 823-2080
CHICAGO LAKE FAMILY DENTAL LLC
Clinic/Center (Dental)
2900 CHICAGO AVE
MINNEAPOLIS, MN 55407
Hennepin County (612) 823-2080
DANIELLE MARIE RODGERS RDH, DT
Dental Therapist
2900 CHICAGO AVE
MINNEAPOLIS, MN 55407
Hennepin County (612) 823-2080

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 Chicago Lake Dental's NPI number?

The NPI number for Chicago Lake Dental is 1497936389. It was assigned to this organization in the NPPES registry on November 19, 2007.

Where is Chicago Lake Dental located?

Chicago Lake Dental is located at 2900 Chicago Ave, Minneapolis, MN 55407. The listed phone number is (612) 823-2080.

What is Chicago Lake Dental's specialty?

The primary specialty registered for this NPI is Dentist, specializing in General Practice, with taxonomy code 1223G0001X.

When was this NPI record last updated?

The NPPES record for Chicago Lake Dental was last updated on November 19, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 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.