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CORDELL LAKE, D.D.S., LLC
NPI 1619446077
Clinic/Center - Dental in Farmington, MO

Active since November 15, 2018
12 E HARRISON ST, FARMINGTON, MO 63640(573) 756-4344 Get Directions Write a Review

NPPES record last updated: November 15, 2018. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Cordell Lake, D.d.s., Llc NPPES

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

CORDELL LAKE, D.D.S., LLC (NPI 1619446077) is a healthcare organization registered as a dental in Farmington, Missouri and active in the NPI registry since November 2018. The organization lists Cordell Lake, General Dentist, as its authorized official.

NPPES Registry Identity

NPI1619446077
Entity TypeOrganization
Primary Taxonomy261QD0000X
Legal Business NameCORDELL LAKE, D.D.S., LLC
Location Address12 E HARRISON STFarmington, MO 63640-1859
Mailing Address3145 Cross Creek DrCamdenton, MO 65020-9377 · (816) 728-1630
Phone(573) 756-4344
Organization SubpartNo
Authorized OfficialCordell LakeGeneral Dentist · (816) 728-1630
Enumeration DateNovember 15, 2018
✔ NPI 1619446077 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · DentalAmbulatory Health Care Facilities
Taxonomy Code261QD0000X
12 E HARRISON ST, Farmington, MO 63640
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Other Providers at the Same Location NPPES 2

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

DR. CORDELL LAKE DDS
Dentist
12 E HARRISON ST
FARMINGTON, MO 63640
St. Francois County (573) 756-4344
TIMOTHY M. O'BRYAN DDS, LLC
Clinic/Center (Dental)
12 E HARRISON ST
FARMINGTON, MO 63640
St. Francois County (573) 756-4344

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 Cordell Lake, D.D.S., LLC's NPI number?

The NPI number for Cordell Lake, D.D.S., LLC is 1619446077. It was assigned to this organization in the NPPES registry on November 15, 2018.

Where is Cordell Lake, D.D.S., LLC located?

Cordell Lake, D.D.S., LLC is located at 12 E Harrison St, Farmington, MO 63640. The listed phone number is (573) 756-4344.

What is Cordell Lake, D.D.S., LLC'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 Cordell Lake, D.D.S., LLC was last updated on November 15, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 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.