1. Home
  2. Directory
  3. Idaho
  4. Boise
  5. Dentist
  6. NPI Profile

LAKE HARBOR DENTAL
NPI 1639310089
Dentist - General Practice in Boise, ID

Active since March 16, 2009
5355 W STATE ST, BOISE, ID 83703(208) 853-4687(208) 853-4690 Get Directions Write a Review

NPPES record last updated: March 16, 2009. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Lake Harbor Dental NPPES

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

LAKE HARBOR DENTAL (NPI 1639310089) is a healthcare organization registered as a general practice in Boise, Idaho and active in the NPI registry since March 2009. The organization lists Michael Eugene Peterson, President, as its authorized official.

NPPES Registry Identity

NPI1639310089
Entity TypeOrganization
Primary Taxonomy1223G0001X
Legal Business NameLAKE HARBOR DENTAL
Location Address5355 W STATE STBoise, ID 83703-3333
Mailing Address5355 W State StBoise, ID 83703-3333 · (208) 853-4687 · Fax (208) 853-4690
Phone(208) 853-4687
Fax(208) 853-4690
Organization SubpartNo
Authorized OfficialMichael Eugene PetersonPresident · (208) 853-4687
Enumeration DateMarch 16, 2009
✔ NPI 1639310089 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · General PracticeDental Providers
Taxonomy Code1223G0001X
Licenses✔ Licensed in ID · D3044✔ Licensed in ID · D4142
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.
5355 W STATE ST, Boise, ID 83703
Open in Google Maps ↗

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-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.

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 PLLC
Clinic/Center (Dental)
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's NPI number?

The NPI number for Lake Harbor Dental is 1639310089. It was assigned to this organization in the NPPES registry on March 16, 2009.

Where is Lake Harbor Dental located?

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

What is Lake Harbor 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 Lake Harbor Dental was last updated on March 16, 2009. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 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.