Amanda Lathe, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

1001848-15 Issued in WI

Practice address

7155 N Port Washington Rd
Glendale, WI 53217-3841

Phone

(414) 928-2518

NPI assigned

Jun 11, 2018

Last updated

Feb 1, 2022By 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 1

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.

• The Kids Dentist LLC

  • Pediatric Dentistry
  • Mequon, WI
  • NPI 1407257108
  NPD (past)

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

{
    "created_epoch": "1528675200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643673600000",
    "number": "1225521545",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2783 S DELAWARE AVE",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532072343",
            "telephone_number": "815-440-7932"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7155 N PORT WASHINGTON RD",
            "city": "GLENDALE",
            "state": "WI",
            "postal_code": "532173841",
            "telephone_number": "414-928-2518"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LATHE",
        "first_name": "AMANDA",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-11",
        "last_updated": "2022-02-01",
        "certification_date": "2022-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WI",
            "license": "1001848-15",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Noel L'Esperance, DAT, ATR-BC, LPC
• Lakeshore Family Dental Center LLC
• Lakeshore Rheumatology, LLC
• Kellie Marie Lanza, MSCCC-SLP
• Karen Ann Laporte, OTR
• Lauren Lathers, LPC, CSAC, ICS
• Ruth Lawrence, M.S., CF-SLP
• Christine T Le Grand, LPC, ATRL-BC
• Christine Le, PHARMD.
• Shane Leach, LCSW

• Dentist in Glendale, WI
• Providers in Glendale, WI by specialty
• Dentist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2022; 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.