NPIMap

Organization Active NPI

Lakehaven Dental

  • General Practice Dentistry
  • Langley, OK
National Provider Identifier
1417329988
Registry record updated Oct 23, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
LAKEHAVEN DENTAL
Practice address
758 Hwy 28
Langley, OK 74350-0339
Phone
(918) 782-9744
NPI assigned
Oct 23, 2015
Last updated
Oct 23, 2015By the provider in NPPES
Organization subpart
Yes
Parent organization
LAKEHAVEN DENTALAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 23, 2015

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

Authorized official

Name
Stefan HackerNPI 1114916244
Title
President
Phone
(918) 787-7900

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X NU Primary

Addresses

Primary practice location

758 Hwy 28
Langley, OK 74350-0339

Mailing address

PO Box 339
Langley, OK 74350-0339
Phone (918) 782-9744

National Provider Directory

National Provider Directory
Tax ID family
Lakehaven Dental2 organizations share this tax ID, including this one
Part of
Lakehaven Dental

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1445558400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1445558400000",
    "number": "1417329988",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 339",
            "city": "LANGLEY",
            "state": "OK",
            "postal_code": "743500339",
            "telephone_number": "918-782-9744"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "758 HWY 28",
            "city": "LANGLEY",
            "state": "OK",
            "postal_code": "743500339",
            "telephone_number": "918-782-9744"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKEHAVEN DENTAL",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "LAKEHAVEN DENTAL",
        "enumeration_date": "2015-10-23",
        "last_updated": "2015-10-23",
        "status": "A",
        "authorized_official_last_name": "HACKER",
        "authorized_official_first_name": "STEFAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "918-787-7900"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Langley, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2015; 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.