Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days.
Organization
LAKESIDE ORTHOPEDIC INSTITUTE, LLC
Active
Organization
LAKESIDE ORTHOPEDIC INSTITUTE, LLC
Active
Parent organization
LAKESIDE ORTHOPEDIC INSTITUTE, LLC
Other names
Lakeside Primary Care
Organization subpart
Yes
Provider details
NPI number
Legal business name
LAKESIDE ORTHOPEDIC INSTITUTE, LLC
Authorized official
DANIEL EDWARD HEINER (AUTHORIZED OFFICIAL)
(928) 505-5555
Entity
Organization
Contact information
Practice address
1720 MESQUITE AVE STE 100, LAKE HAVASU CITY, AZ 86403-5602
(928) 505-5555
(928) 505-5557
Mailing address
25 RIVIERA BLVD, LAKE HAVASU CITY, AZ 86403-5694
(928) 505-5555
(928) 505-5557
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
NULL
207Q00000X
Family Medicine Physician
Primary
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
—
NULL
Other
Enumeration date
03/15/2022
Last updated
04/22/2026
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign upProduct
Developers