Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Blue Lake Smiles

Organization Pediatric Dentistry · NPI 1598627820

Blue Lake Smiles is a Pediatric Dentistry in Fond Du Lac, Wisconsin. Registered with an NPI since 2025.

In the registry since
2025

Practice location Address checks out

845 S Main St Ste 130
Fond Du Lac, WI 54935-6116
Phone: (920) 581-8505
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Pediatric Dentistry (primary) Taxonomy 1223P0221X

Record details

NPI number1598627820
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Gaurav Jain — Pediatric Dentist · (612) 308-2244
Other names Blue Lake Smiles Pediatric Dentistry
NPI enumeratedNovember 25, 2025
Last updated in NPPESNovember 25, 2025
Certification dateNovember 12, 2025
Mailing address10749 N Tree Sparrow Dr, Mequon, WI 53097

Other providers in Fond Du Lac