Implant SpecialistFinder

Lake Street Dental

Prosthodontics practice in Minneapolis, MN

Registered specialistLicense # listed (MN)

Call (612) 724-1717Send a messageMap ↗

Public-record details

Address
1508 E Lake St, Minneapolis, MN 55407
Phone
(612) 724-1717
Listed under
Prosthodontists, Specialty practices
NPI
1184829509
NPI status
Active in the NPPES registry
Provider type
Organization (practice, clinic or company)
Registered specialty (self-reported taxonomy)
Prosthodontics (1223P0700X)
License number on NPI record
D12007 (MN)
Authorized official
Renee Good, DDS, MS, Periosontist
NPI first issued
Jun 16, 2007
NPI record last updated
Sep 11, 2025

NPI 1184829509 is active in the federal NPPES registry (CMS) with Prosthodontics, an ADA-recognized dental specialty, as its primary taxonomy; license D12007 (MN) is listed on the record. Source: NPPES NPI Registry (CMS) (record). Data as of 2026-09-30.

What these registry facts mean

The NPI (National Provider Identifier) is the federal ID every HIPAA-covered provider uses to bill insurance. This NPI belongs to an organization, so it may cover several clinicians at this location. The specialty is the taxonomy the provider chose when registering; NPPES does not check it. A license number here is what the provider entered — confirm it with the state board before you rely on it. Prosthodontists specialize in restoring and replacing teeth: crowns, bridges, dentures and the teeth that go on top of implants, including full-arch fixed bridges. Dentists who are not specialists can also place implants; the specialty here is the one the provider registered as primary.

View NPI 1184829509 in the official registry ↗

Checking credentials: the specialty shown is the one this provider registered with the NPI system. Your state dental board's license lookup confirms the license, and the American Board of Prosthodontics, the American Board of Oral and Maxillofacial Surgery and the American Board of Periodontology each list their board-certified members.

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