Valerie E Lake, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

12010452A Issued in IN

Practice address

6211 Covington Rd
Fort Wayne, IN 46804-7311

Phone

(260) 432-1579

Fax

(260) 432-4540

NPI assigned

Apr 3, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Dr. Valerie E Lake Professional name

Medicare fee-for-service enrollment

Enrolled in IN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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

• Valerie E Lake, DDS, LLC

  • Dental Clinic/Center
  • Fort Wayne, IN
  • NPI 1053062430
  NPD Authorized official
• R M & M R Stetzel DDS Inc

  • General Practice Dentistry
  • Fort Wayne, IN
  • NPI 1356463327
  NPD (past)

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

{
    "created_epoch": "1175558400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636329600000",
    "number": "1114048121",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6211 COVINGTON RD",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468047311",
            "telephone_number": "260-432-1579",
            "fax_number": "260-432-4540"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6211 COVINGTON RD",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468047311",
            "telephone_number": "260-432-1579",
            "fax_number": "260-432-4540"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAKE",
        "first_name": "VALERIE",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-03",
        "last_updated": "2021-11-08",
        "certification_date": "2021-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IN",
            "license": "12010452A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "VALERIE",
            "last_name": "LAKE",
            "middle_name": "E",
            "prefix": "DR.",
            "credential": "D.D.S. L.L.C",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Andrea N Lahrman, AGPCNP-BC
• Iraida M Lainez, M.D.
• Curtis E Lake
• Mindy M Lake
• Stacy Ellen Lake, ATC
• Lakewood Family Dental Inc
• Anupma Lal, MD
• Naveen Lal, M.D.
• Lam Medical, LLC
• Christine Nguyen Lam, DMD

• General Practice Dentistry in Fort Wayne, IN
• Providers in Fort Wayne, IN by specialty
• General Practice Dentistry in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.