OrganizationActive
Moore Lake Dental
NPI 1386035590 · Dentist · Fridley, MN
Moore Lake Dental is a Dentist organization in Fridley, MN (NPI 1386035590).
Provider details
- NPI number
- 1386035590
- Entity type
- Organization
- Primary specialty
- DentistDental Providers
- Organization subpart
- No
- Authorized official
- Lisa Perez, Owner(612) 414-2182
- License
- D10520 (MN)
Specialties & taxonomies
Dental Providers
Profile Score
Established profile(74/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
11 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
6230 Highway 65 Ne
Suite 105
Fridley, MN 55432-5107
Phone: (763) 571-5497
Street-level locationGet directions
Mailing address
6230 Highway 65 Ne
Fridley, MN 55432-5107
Registry dates
- Enumerated
- 2015-02-10
- Last updated
- 2015-02-10
Frequently asked questions
- What is Moore Lake Dental's NPI number?
- Moore Lake Dental's National Provider Identifier (NPI) is 1386035590, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Moore Lake Dental?
- Moore Lake Dental is classified in the NPPES registry as Dentist (Dental Providers).
- Where is Moore Lake Dental located?
- Moore Lake Dental's practice location on file with NPPES is 6230 Highway 65 Ne, Fridley, MN 55432-5107.
- What is Moore Lake Dental's phone number?
- The practice phone number listed in the NPPES registry for Moore Lake Dental is (763) 571-5497.
- Who is the authorized official for Moore Lake Dental?
- The authorized official listed on Moore Lake Dental's NPPES record is Lisa Perez, Owner. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Moore Lake Dental's NPI active?
- Yes — Moore Lake Dental's NPI (1386035590) is active in the NPPES registry as of the last update on 2015-02-10.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.