Pauline P Reilly-Lake, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DN1858229 Issued in MA

Practice address

16 Haverhill St Ste 1
Andover, MA 01810-3000

Phone

(978) 699-9051

NPI assigned

May 23, 2018

Last updated

Jan 12, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Alepmed Inc

  • Dental Clinic/Center
  • Haverhill, MA
  • NPI 1376052282
  NPD (past)
• William T Benson DMD PC

  • General Practice Dentistry
  • Newburyport, MA
  • NPI 1427231075
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1527033600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705017600000",
    "number": "1104317494",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18 MOUNT PLEASANT AVE",
            "city": "IPSWICH",
            "state": "MA",
            "postal_code": "019382116",
            "telephone_number": "978-790-8278"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16 HAVERHILL ST STE 1",
            "city": "ANDOVER",
            "state": "MA",
            "postal_code": "018103000",
            "telephone_number": "978-699-9051"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REILLY-LAKE",
        "first_name": "PAULINE",
        "middle_name": "P",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-05-23",
        "last_updated": "2024-01-12",
        "certification_date": "2024-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MA",
            "license": "DN1858229",
            "primary": true
        },
        {
            "code": "204E00000X",
            "taxonomy_group": "",
            "desc": "Oral & Maxillofacial Surgery",
            "state": "MA",
            "license": "DL13614",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Katie Randall-Sungar, PSY.D.
• Ramya Rangamannar, PSY.D.
• Donald Earl Rankey III
• Rehabilitation Network of New England
• Ilana Reife, PHD
• Christine Repsha, FNP-C
• Elaine Richards
• Kelvey Richards
• Fiona S Richardson
• Wendy J Ring, M.S. CCC-A

• General Practice Dentistry in Andover, MA
• Providers in Andover, MA by specialty
• General Practice Dentistry in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.