Lake Street Dental is a Dental Clinic in Minneapolis, Minnesota. It is located at 1508 E Lake St, Minneapolis, MN and its contact number is 612-724-1717. The authorized person for Lake Street Dental is Renee Camara Good
who is Periosontist of the clinic and their contact number is 612-724-1717. The primary license number for Lake Street Dental is D12007 (Prosthodontics) in Minnesota.
Lake Street Dental Clinic caters to patients of all ages for their dental care needs. Dentists at the clinic are responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.
Complete Clinic Profile:
Lake Street Dental Clinic speciality, address, contact phone number and fax are as below.
Patients can call on the below given phone number for appointments.
| Name: | Lake Street Dental |
| Specialization: | General Practice Dentistry |
| Clinic Address: | 1508 E Lake St, Minneapolis,
Minnesota, 55407-1720 |
| Phone: | 612-724-1717 |
Authorized/Official Person Profile:
Officially authorized person to contact for any management issues or complaints for this clinic are as below. Person's position and contact details are also mentioned below.
| Name: | Renee Camara Good |
| Position: | Periosontist |
| Contact Number: | 612-724-1717 |
Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS).
NPI details for Lake Street Dental clinic are as mentioned below.
| NPI Number: | 1184829509 |
| NPI Enumeration Date: | 16 Jun, 2007 |
| NPI Last Update On: | 11 Sep, 2025 |
Medical Licenses:
Organizations can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Lake Street Dental are as mentioned below.
| Specialization | License Number | State | Status | |
| Prosthodontics | D12007 | Minnesota | Primary | |
| General Practice | D11889 | Minnesota | Secondary | |
| Periodontics | D11718 | Minnesota | Secondary | |
Business Mailing Address:
Business mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned address.
| Address: | Lake Street Dental
1508 E Lake St,
Minneapolis, Minnesota |
| Zip: | 55407-1720 |
| Phone Number: | 612-724-1717 |
Patients can reach Lake Street Dental at
1508 E Lake St, Minneapolis, Minnesota or can
call to book an appointment on 612-724-1717.
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**Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on
08 December, 2025.