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

Lakeside Dental Center Inc

Organization Dentist · NPI 1407137151

Lakeside Dental Center Inc is a Dentist in Chicago, Illinois. Licensed in Illinois. Registered with an NPI since 2011.

Licensed in
IL
In the registry since
2011
What do these letters mean?
Inc — Incorporated
A form of business registration, not a clinical qualification.

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Practice location Address checks out

2218 S Michigan Ave
Chicago, IL 60616-2126
Phone: (312) 842-7133
Fax: (312) 842-2214
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Dentist (primary) Taxonomy 122300000X · Licence 019010535 (IL)

Record details

NPI number1407137151
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Marvin Kozlov — Owner · (312) 842-7133
NPI enumeratedSeptember 7, 2011
Last updated in NPPESSeptember 7, 2011
Mailing address2218 S Michigan Ave, Chicago, IL 60616-2126

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