Lakeshore Dental Care, PLLC
Dentist, General Practice in Hamburg, NY. Organization (NPI-2).
NPI number1962856237
StatusActive
Last updated in NPPESApr 22, 2016
Details
- NPI
- 1962856237
- Entity type
- Organization (NPI-2)
- Legal business name
- Lakeshore Dental Care, PLLC
- Organization subpart
- No
- Enumeration date
- Apr 22, 2016
- Last updated
- Apr 22, 2016
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1223G0001X | Dentist, General Practice | 056041 | NY | Yes |
Practice location
5020 Lake Shore RdHamburg, NY 14075-5719
Phone 716-627-7200
Mailing address
5020 Lake Shore RdHamburg, NY 14075-5719
Authorized official
Christian Robert Mitchell
Owner
7169094775
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