Ruby J Lake
Individual provider Active NPI Dentist · Frederiksted, VI
NPI 1487907192 · NPPES record last updated Oct 18, 2012
Key facts
- NPI
- 1487907192
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dentist 122300000X
- License
- 708 (VI)
- Practice address
- 16 Strand Street
Frederiksted, VI 00840 - Phone
- (340) 772-1616
- Fax
- (340) 772-1616
- NPI assigned
- Oct 18, 2012
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 708 | VI | MD | Dentist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 708 | VI | Yes |
Addresses
Primary practice location
16 Strand Street
Frederiksted, VI 00840
Mailing address
414 Strand Street
Frederiksted, VI 00840
Phone (340) 772-1616
Other providers in Frederiksted, VI
- Abd Alrahman Kara Hammoudeh
- Shavell Ahleen Karel
- Emily Karr
- Candace Kwakye
- Dannielle Kyrillos
- Jessica Marie Lignelli
- Jozette C. Matthews
- Stephanie T McIntosh Luis
- Tarik Malachi McMillan
- Medical Health &DME Supplies
All providers in Frederiksted, VI · Dentist in U.S. Virgin Islands
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 18, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.