Deborah Starr Lake, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

7734 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

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Female

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

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• John F Lake DDS & Deborah Starr

  • General Practice Dentistry
  • Ontario, OR
  • NPI 1487862009
  NPD (past)

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

{
    "created_epoch": "1155945600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1750495180",
    "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": "STARR LAKE",
        "first_name": "DEBORAH",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OR",
            "license": "7734",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• St Alphonsus Professional Medical Services LLC
• Star Center
• Stark Medical Group PC
• Stark Medical, PC
• Jody A. Stark, NP
• David Rood Starr, PH.D.
• Frederick R Starr, CRNA
• Suzanne Elizabeth Steele
• Si Robin Steinberg, M.D.
• Stacie Tawnia Stewart

• 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 Jul 8, 2007; 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.