R L Lake DDS Inc

Primary specialty

DentistTaxonomy code 122300000X

License

4059 Issued in OK

Legal business name

R L LAKE DDS INC

Practice address

200 Dallas St
Talihina, OK 74571-2402

Phone

(918) 567-3961

Fax

(918) 567-3424

NPI assigned

Aug 16, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Ramon L Lake Jr., DDS

Title

President R L Lake DDS Inc

Phone

(918) 567-3961

Specialties & licenses 1

Addresses

Other names 1

• Talihina Family Dentistry Doing business as

Locations

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

{
    "created_epoch": "1155686400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1190160000000",
    "number": "1669585402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 DALLAS ST",
            "city": "TALIHINA",
            "state": "OK",
            "postal_code": "745712402",
            "telephone_number": "918-567-3961",
            "fax_number": "918-567-3424"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 DALLAS ST",
            "city": "TALIHINA",
            "state": "OK",
            "postal_code": "745712402",
            "telephone_number": "918-567-3961",
            "fax_number": "918-567-3424"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "R L LAKE DDS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-16",
        "last_updated": "2007-09-19",
        "status": "A",
        "authorized_official_last_name": "LAKE",
        "authorized_official_first_name": "RAMON",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PRESIDENT R L LAKE DDS INC",
        "authorized_official_telephone_number": "918-567-3961",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "OK",
            "license": "4059",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Talihina Family Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Dentist in Talihina, OK
• Providers in Talihina, OK by specialty
• Dentist in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2007; 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.