MEDICARE: CLEAR LAKES DENTAL

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QD0000X	Dental Clinic/Center

General Provider Information

NPI Number	:	1932050499
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CLEAR LAKES DENTAL

Provider Business Mailing Address
First Line	:	1012 COUNTY ROAD 42 W
Second Line	:
City	:	BURNSVILLE
State	:	MN
Zip	:	55337-4429
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1012 COUNTY ROAD 42 W
Second Line	:
City	:	BURNSVILLE
State	:	MN
Zip	:	55337-4429
Country	:	US
Telephone Number	:	586-871-3173
Fax Number	:

Authorized Official
Title or Position	:	DENTIST
Name	:	AAKEEB AMIN
Credential	:	DDS
Telephone Number	:	586-871-3173

Provider Enumeration Date	:	02/09/2026
Last Update Date	:	02/09/2026

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Directions to “CLEAR LAKES DENTAL ” Practice Location

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