OrganizationActive
Lake Street Family Dental PA
NPI 1083096085 · Dentist · Mora, MN
Lake Street Family Dental PA is a Dentist organization in Mora, MN (NPI 1083096085).
Provider details
- NPI number
- 1083096085
- Entity type
- Organization
- Primary specialty
- DentistDental Providers
- Organization subpart
- No
- Authorized official
- Steven Holcombe, President(763) 350-6234
- License
- D13567 (MN)
Specialties & taxonomies
Dental Providers
Profile Score
Established profile(73/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
10 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
119 Lake St S
Suite 1
Mora, MN 55051-1576
Phone: (320) 679-2435
Street-level locationGet directions
Mailing address
10799 251st Ave Nw
Zimmerman, MN 55398-4558
Registry dates
- Enumerated
- 2015-06-25
- Last updated
- 2015-06-25
Frequently asked questions
- What is Lake Street Family Dental PA's NPI number?
- Lake Street Family Dental PA's National Provider Identifier (NPI) is 1083096085, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Lake Street Family Dental PA?
- Lake Street Family Dental PA is classified in the NPPES registry as Dentist (Dental Providers).
- Where is Lake Street Family Dental PA located?
- Lake Street Family Dental PA's practice location on file with NPPES is 119 Lake St S, Mora, MN 55051-1576.
- What is Lake Street Family Dental PA's phone number?
- The practice phone number listed in the NPPES registry for Lake Street Family Dental PA is (320) 679-2435.
- Who is the authorized official for Lake Street Family Dental PA?
- The authorized official listed on Lake Street Family Dental PA's NPPES record is Steven Holcombe, President. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Lake Street Family Dental PA's NPI active?
- Yes — Lake Street Family Dental PA's NPI (1083096085) is active in the NPPES registry as of the last update on 2015-06-25.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.