OrganizationActive
Lakewood Family Dental Inc
NPI 1386062768 · Dentist · Fort Wayne, IN
Lakewood Family Dental Inc is a Dentist organization in Fort Wayne, IN (NPI 1386062768).
Provider details
- NPI number
- 1386062768
- Entity type
- Organization
- Primary specialty
- DentistDental Providers
- Organization subpart
- No
- Authorized official
- Srinivasulu Kakollu, President(732) 379-0953
- License
- 019028401 (IL)
Specialties & taxonomies
Dental Providers
Profile Score
Detailed profile(76/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
12 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
4512 Parnell Ave
Fort Wayne, IN 46825-5836
Phone: (732) 379-0953
Street-level locationGet directions
Mailing address
1407 N Veterans Pkwy
Bloomington, IL 61704-6630
Registry dates
- Enumerated
- 2014-04-02
- Last updated
- 2014-04-03
Frequently asked questions
- What is Lakewood Family Dental Inc's NPI number?
- Lakewood Family Dental Inc's National Provider Identifier (NPI) is 1386062768, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Lakewood Family Dental Inc?
- Lakewood Family Dental Inc is classified in the NPPES registry as Dentist (Dental Providers).
- Where is Lakewood Family Dental Inc located?
- Lakewood Family Dental Inc's practice location on file with NPPES is 4512 Parnell Ave, Fort Wayne, IN 46825-5836.
- What is Lakewood Family Dental Inc's phone number?
- The practice phone number listed in the NPPES registry for Lakewood Family Dental Inc is (732) 379-0953.
- Who is the authorized official for Lakewood Family Dental Inc?
- The authorized official listed on Lakewood Family Dental Inc's NPPES record is Srinivasulu Kakollu, President. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Lakewood Family Dental Inc's NPI active?
- Yes — Lakewood Family Dental Inc's NPI (1386062768) is active in the NPPES registry as of the last update on 2014-04-03.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.