John F Lake, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

7733 Issued in OR

Practice address

286 SW 4TH St
Ontario, OR 97914-2610

Phone

(541) 889-7050

Fax

(541) 889-6495

NPI assigned

Aug 19, 2006

Sex

Male

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

Enrolled in OR

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

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

{
    "created_epoch": "1155945600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1455062400000",
    "number": "1619081031",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "286 SW 4TH ST",
            "city": "ONTARIO",
            "state": "OR",
            "postal_code": "979142610",
            "telephone_number": "541-889-7050",
            "fax_number": "541-889-6495"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "286 SW 4TH ST",
            "city": "ONTARIO",
            "state": "OR",
            "postal_code": "979142610",
            "telephone_number": "541-889-7050",
            "fax_number": "541-889-6495"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAKE",
        "first_name": "JOHN",
        "middle_name": "F",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-19",
        "last_updated": "2016-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OR",
            "license": "7733",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Charlotte Kreftmeyer
• Brian Kubesh
• Jennifer Elizabeth Kunasek, CRM
• Heather Rae Kurth, DPT
• Christa Ray Lake
• Evelyn Karina Lamas
• Tami Beth Lamb, NP
• Lorraine L Lambert, LMFT
• Rogelio Lara, ADES, CADCII
• Hannah Larcade

• General Practice Dentistry in Ontario, OR
• Providers in Ontario, OR by specialty
• General Practice Dentistry in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2016; 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.