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 25, 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 25 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.