Lakewood Family Dental is a Dental Clinic in Bloomington, Illinois. It is located at 1407 N Veterans Pkwy, Suite 12, Bloomington, IL and its contact number is 732-379-0953. The authorized person for Lakewood Family Dental is Dr. Srinivasulu Kakollu
who is President of the clinic and their contact number is 732-379-0953. The primary license number for Lakewood Family Dental is 019-028401 (General Practice) in Illinois.
Lakewood Family 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:
Lakewood Family Dental Clinic speciality, address, contact phone number and fax are as below.
Patients can call on the below given phone number for appointments.
| Name: | Lakewood Family Dental |
| Specialization: | General Practice Dentistry |
| Clinic Address: | 1407 N Veterans Pkwy, Suite 12, Bloomington,
Illinois, 61704-6630 |
| Phone: | 732-379-0953 |
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: | Dr. Srinivasulu Kakollu |
| Position: | President |
| Contact Number: | 732-379-0953 |
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 Lakewood Family Dental clinic are as mentioned below.
| NPI Number: | 1154675304 |
| NPI Enumeration Date: | 08 Nov, 2012 |
| NPI Last Update On: | 08 Nov, 2012 |
Medical Licenses:
Organizations can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Lakewood Family Dental are as mentioned below.
| Specialization | License Number | State | Status | |
| General Practice | 019-028401 | Illinois | Primary | |
Business Mailing Address:
Business mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned address.
| Address: | Lakewood Family Dental
1407 N Veterans Pkwy, Suite 12
Bloomington, Illinois |
| Zip: | 61704-6630 |
| Phone Number: | 732-379-0953 |
Patients can reach Lakewood Family Dental at
1407 N Veterans Pkwy, Suite 12, Bloomington, Illinois or can
call to book an appointment on 732-379-0953.
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**Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on
08 December, 2025.