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

Lake Shore Retina, SC Corp

Organization Ophthalmology Physician · NPI 1255564258

Lake Shore Retina, SC Corp is an Ophthalmology Physician in Dandridge, Tennessee. Registered with an NPI since 2009.

In the registry since
2009
What do these letters mean?
Corp — Corporation
A form of business registration, not a clinical qualification.

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Practice location Address checks out

1208 Gay St
Dandridge, TN 37725-4720
Phone: (865) 484-9948
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Ophthalmology Physician (primary) Taxonomy 207W00000X

Record details

NPI number1255564258
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Srilakshmi Maguluri — President · (773) 677-2962
NPI enumeratedAugust 25, 2009
Last updated in NPPESJanuary 10, 2024
Certification dateJanuary 10, 2024
Mailing addressPo Box 1751, Dandridge, TN 37725-1751