Lake Family Dentistry

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

2006014707 Issued in MO

Legal business name

LAKE FAMILY DENTISTRY

Practice address

1037 Palisades Blvd Ste 9
Osage Beach, MO 65065

Phone

(573) 348-9888

Fax

(573) 348-9894

NPI assigned

Jul 2, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Mark S Lake, DDSNPI 1356479539

Title

Dentist

Phone

(573) 348-9888

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Mark S. Lake, D.D.S.

  • General Practice Dentistry
  • Osage Beach, MO
  • NPI 1356479539

  General Practice

  NPD (past) Authorized official

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

{
    "created_epoch": "1214956800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1214956800000",
    "number": "1457514259",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1037 PALISADES BLVD STE 9",
            "city": "OSAGE BEACH",
            "state": "MO",
            "postal_code": "650653340",
            "telephone_number": "573-348-9888",
            "fax_number": "573-348-9894"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1037 PALISADES BLVD STE 9",
            "city": "OSAGE BEACH",
            "state": "MO",
            "postal_code": "65065",
            "telephone_number": "573-348-9888",
            "fax_number": "573-348-9894"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKE FAMILY DENTISTRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-07-02",
        "last_updated": "2008-07-02",
        "status": "A",
        "authorized_official_last_name": "LAKE",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "573-348-9888",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "MO",
            "license": "2006014707",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brandon Joshua Labe, DMD
• Lake Area Hearing Solutions LLC
• Lake Behavioral Health
• Lake Behavioral Health Associates, LLC
• Lake Cardiovascular Institute, PC
• Lake Internal Med Special
• Lake of the Ozarks Pain Management Services, Inc
• Lake Orthopedic Group, Inc.
• Lake Ozark Anesthesia & Associates, Inc
• Lake Ozark Retirement Center, Inc.

• All providers in Osage Beach, MO
• General Practice Dentistry in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2008; 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.