Kevin Joseph Lake in New Providence - Dentist
Kevin Joseph Lake - NPI 1083638399
Kevin Joseph Lake is a Dentist in New Providence, New Jersey. Kevin Joseph Lake practices all healthcare services and medical treatments related to Dentist. The NPI Number for Kevin Joseph Lake is 1083638399. The last update date is 2007-07-08.
Kevin Joseph Lake's current location address is 5 Ethan Dr, New Providence, New Jersey. You can contact this provider via phone number 9084645270. The mailing address for Kevin Joseph Lake is 5 Ethan Dr, New Providence, New Jersey. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Kevin Joseph Lake |
|---|---|
| Address | 5 Ethan Dr, New Providence, New Jersey |
| Phone Number | 9084645270 |
| Fax Number | |
| Sole Proprietor | Y |
| Credentials | DMD |
NPI Number Detail
| NPI Number | 1083638399 |
|---|---|
| Provider Enumeration Date | 2006-07-27 |
| Last Updated Date | 2007-07-08 |
Provider Mailing Address Detail
| Address | 5 Ethan Dr |
|---|---|
| City | New Providence |
| State | New Jersey (NJ) |
| Post Code | 79741604 |
| Phone Number | 9084645270 |
| Fax Number |
Provider's Primary Taxonomy Detail
| Speciality | Dentist |
|---|---|
| Taxonomy | 122300000X |
| Licence No | 22DI02044100 |
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Definition: A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: denti |
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What is the unique 10-digit identifier code issued to Kevin Joseph Lake by the Centers for Medicare & Medicaid Services?
The Kevin Joseph Lake has been assigned the NPI (National Provider Identifier) 1083638399 by the CMS (Centers for Medicare & Medicaid Services). This 10-digit code serves as a unique identification number for healthcare providers.
Could you share the physical location details of Kevin Joseph Lake?
The Kevin Joseph Lake is situated at 5 Ethan Dr, in the city of New Providence, state of NJ, with the zip code 79741604.
What is the Kevin Joseph Lake's specialty and taxonomy code?
The Kevin Joseph Lake's specialty is Dentist, and the corresponding taxonomy code is 122300000X.
On what date did the Centers for Medicare & Medicaid Services issue the 1083638399 to Kevin Joseph Lake?
The Kevin Joseph Lake received its 1083638399 assignment from the Centers for Medicare & Medicaid Services on 2006-07-27.
When was the information pertaining to Kevin Joseph Lake most recently updated or revised?
The details related to Kevin Joseph Lake, including its address, specialty, and other relevant information, were last updated or revised on 2007-07-08.