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

Lake Family and Cosmetic Dentistry

Organization Dentist · NPI 1073936084

Lake Family and Cosmetic Dentistry is a Dentist in Fort Worth, Texas. Licensed in Texas. Registered with an NPI since 2014.

Licensed in
TX
In the registry since
2014

Practice location Address checks out

4968 Overton Ridge Blvd
Fort Worth, TX 76132-1909
Phone: (817) 263-0181
Show map & directions

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

Specialties & licences

Dentist (primary) Taxonomy 122300000X · Licence 25182 (TX)

Record details

NPI number1073936084
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Kimberly Lake — Owner/ President · (817) 263-0181
Other names Lake Family Dental
NPI enumeratedJanuary 27, 2014
Last updated in NPPESJanuary 27, 2014
Mailing address4968 Overton Ridge Blvd, Fort Worth, TX 76132-1909

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