Newly Listed Provider — this NPI profile has been added to the NPI registry within the last 90 days.

LAKESIDE ENT & FACIAL PLASTIC SURGERY LLC
NPI 1578468591
Otolaryngology - Otolaryngology/Facial Plastic Surgery in Watertown, SD

Q: What is Lakeside Ent & Facial Plastic Surgery LLC's specialty?

The primary specialty registered for this NPI is Otolaryngology, specializing in Otolaryngology/Facial Plastic Surgery, with taxonomy code 207YX0905X.

Active since October 09, 2026

1516 4TH ST NE, WATERTOWN, SD 57201(605) 880-5965 Get Directions Write a Review

NPPES record added: October 9, 2026. Verified against the NPPES registry weekly; last sync: October 11, 2026.

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About Lakeside Ent & Facial Plastic Surgery Llc NPPES

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

LAKESIDE ENT & FACIAL PLASTIC SURGERY LLC (NPI 1578468591) is a healthcare organization registered as an otolaryngology/facial plastic surgery in Watertown, South Dakota and active in the NPI registry since October 2026. The organization lists Jered M Mancell, Physician/medical Director, as its authorized official.

NPPES Registry Identity

NPI1578468591

Entity TypeOrganization

Primary Taxonomy207YX0905X

Legal Business NameLAKESIDE ENT & FACIAL PLASTIC SURGERY LLC

Location Address1516 4TH ST NEWatertown, SD 57201-6824

Mailing Address1516 4th St NeWatertown, SD 57201-6824 · (605) 880-5965

Phone(605) 880-5965

Organization SubpartNo

Authorized OfficialJered M MancellPhysician/medical Director · (605) 880-5965

Enumeration DateOctober 9, 2026

NPPES CertifiedOctober 9, 2026

✔ NPI 1578468591 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOtolaryngology · Otolaryngology/Facial Plastic SurgeryAllopathic & Osteopathic Physicians

Taxonomy Code207YX0905X

Definition

An otolaryngologist who specializes in the diagnosis and surgical treatment of head and neck conditions.

1516 4TH ST NE, Watertown, SD 57201

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Other Providers at the Same Location NPPES 3

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

STEPHANIE L LENARDS PT

Physical Therapist

1516 4TH ST NE
WATERTOWN, SD 57201

Codington County (605) 753-0430

MR. NATHAN LEE BRESKE DPT, ATC

Physical Therapist

1516 4TH ST NE
WATERTOWN, SD 57201

Codington County (605) 753-0430

MS. MICHELLE MARIE MCCORMICK PT

Physical Therapist

1516 4TH ST NE
WATERTOWN, SD 57201

Codington County (605) 753-0430

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 Lakeside Ent & Facial Plastic Surgery LLC's NPI number?

The NPI number for Lakeside Ent & Facial Plastic Surgery LLC is 1578468591. It was assigned to this organization in the NPPES registry on October 9, 2026.

Where is Lakeside Ent & Facial Plastic Surgery LLC located?

Lakeside Ent & Facial Plastic Surgery LLC is located at 1516 4th St NE, Watertown, SD 57201. The listed phone number is (605) 880-5965.

What is Lakeside Ent & Facial Plastic Surgery LLC's specialty?

The primary specialty registered for this NPI is Otolaryngology, specializing in Otolaryngology/Facial Plastic Surgery, with taxonomy code 207YX0905X.

When was this NPI record last updated?

The NPPES record for Lakeside Ent & Facial Plastic Surgery LLC was last updated on October 9, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 days 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.