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LAKE VALLEY DENTAL PLLC
NPI 1720755531
Clinic/Center - Dental in Wheaton, MN

Active since August 28, 2021
1511 BROADWAY, WHEATON, MN 56296(320) 563-4800 Get Directions Write a Review

NPPES record last updated: August 28, 2021. Verified against the NPPES registry weekly; last sync: September 06, 2026.

About Lake Valley Dental Pllc NPPES

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

LAKE VALLEY DENTAL PLLC (NPI 1720755531) is a healthcare organization registered as a dental in Wheaton, Minnesota and active in the NPI registry since August 2021. The organization lists Johnathan Wermers, Dentist, as its authorized official.

NPPES Registry Identity

NPI1720755531
Entity TypeOrganization
Primary Taxonomy261QD0000X
Legal Business NameLAKE VALLEY DENTAL PLLC
Location Address1511 BROADWAYWheaton, MN 56296-1040
Mailing Address1511 BroadwayWheaton, MN 56296-1040 · (320) 563-4800
Phone(320) 563-4800
Organization SubpartNo
Authorized OfficialJohnathan WermersDentist · (605) 770-8667
Enumeration DateAugust 28, 2021
NPPES CertifiedAugust 28, 2021
✔ NPI 1720755531 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · DentalAmbulatory Health Care Facilities
Taxonomy Code261QD0000X
1511 BROADWAY, Wheaton, MN 56296
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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.

MR. JOHNATHAN WERMERS DMD
Dentist
1511 BROADWAY
WHEATON, MN 56296
Traverse County (320) 563-4800
DR. MICHAEL ROBERT MARCHETTI DDS
Dentist (General Practice)
1511 BROADWAY, BOX 84
WHEATON, MN 56296
Traverse County (320) 563-4800

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 Valley Dental PLLC's NPI number?

The NPI number for Lake Valley Dental PLLC is 1720755531. It was assigned to this organization in the NPPES registry on August 28, 2021.

Where is Lake Valley Dental PLLC located?

Lake Valley Dental PLLC is located at 1511 Broadway, Wheaton, MN 56296. The listed phone number is (320) 563-4800.

What is Lake Valley Dental PLLC'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 Lake Valley Dental PLLC was last updated on August 28, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.