NPI age
17 years
Enumerated 2009-03-16
● Active Type 2 · Organization
Lake Harbor Dental
Lake Harbor Dental is 1 of 1099 dentist organizations in Idaho.
Primary specialty
Dentist
Practice locations
1
0 secondary on file
Status
Active
No deactivations on record
Authorized official
Peterson
President
Last NPPES update
2009-03-16
Source: monthly bulk 2026-05
How this organization compares
Across 1099 active dentist providers in Idaho.
NPI age
17 years
≈ at median (18 yr)
Practice locations
1
0 secondary on file
Subspecialties
0
NPI lifetime · 2009 → 2026
2009-03Enumerated in NPPES
2009
2026
Where they practice
Primary practice location
5355 W State St
Boise, ID 837033333
Mailing address
5355 W State St
Boise, ID 837033333
Authorized official
Michael Eugene Peterson, DDS, PA
President
📞 2088534687
Individual providers at this organization
3 individual providers on file at this primary practice address.
- Eric Ballou, DDS Dentist NPI 1952561003
- Michael Peterson, DDS Dentist NPI 1942472691
- Stephen White, D.D.S Dentist NPI 1326066721
Specialties
-
Dentist PrimaryA general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.
Practice context
Multi-provider organization. 3 individual providers on file at this primary address.
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Request a quote →How to verify this organization
- Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
- Verify the organization is in good standing.Cross-check with the state's business registration and any applicable licensing boards.
- Confirm payer enrollment if billing.NPI presence does not guarantee active enrollment with Medicare, Medicaid, or commercial payers.