Lake Street Dental
NPI 1184829509ActiveOrganization· Dentist, Prosthodontics· Minneapolis, MN
Dentist, Prosthodontics in Minneapolis, Minnesota, registered in NPPES in June 2007. The authorized official on file is Renee Camara Good, D.D.S., M.S., Periosontist.
Overview
| NPI | 1184829509 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Jun 16, 2007 |
| Last updated in NPPES | Sep 11, 2025 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Dentist, Prosthodontics Primary | 1223P0700X | D12007 | MN |
| Dentist, General Practice | 1223G0001X | D11889 | MN |
| Dentist, Periodontics | 1223P0300X | D11718 | MN |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Not in the public enrollment file of Oct 1, 2026 |
|---|
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