Supposedly Lightroom 3 has improved noise reduction built-in... I haven't played with it (version 3) yet, but it might be worth checking out. I doubt it's comparable to a stand-alone one, but it's gotta be better than what's there now!
The exif loss is from using the standalone one - the plug-in versions of the various noise reduction problems don't actually save the image, so they won't alter your exif. I would imagine that the standalone versions have the option to retain exif too, maybe buring in the options somewhere, but I don't know for sure (I've only used the plug-ins.)
Like Code, I've used NN a few times as a Lightroom plug-in, but not very often because 1) I tend to avoid using much noise reduction (maybe to my detriment especially as I have zero done in-camera) and 2) it is rather a big pain in the butt, especially the whole leftover TIFF file. If LR3 could integrate comparable quality NR as a built-in feature, that would be fantastic.