Lake Dental of Saratoga, PC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

052845 Issued in NY

Legal business name

LAKE DENTAL OF SARATOGA, PC

Practice address

176 Lake Ave
Saratoga Springs, NY 12866-2529

Phone

(518) 935-0068

Fax

(518) 581-1145

NPI assigned

Nov 3, 2010

Organization subpart

No

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

Authorized official

Name

Mrs. Tracie Lynn Dennis

Title

Book Keeper

Phone

(518) 817-2490

Specialties & licenses 2

Addresses

Other identifiers 2

Locations

Practitioners 2

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

• Stephanie Fisher

  • General Practice Dentistry
  • Saratoga Springs, NY
  • NPI 1083029136
  NPD (past)
• Damon Ashley Anderson, D.D.S.

  • Dentist
  • Laguna Niguel, CA
  • NPI 1144330143
  NPD (past)

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

{
    "created_epoch": "1288742400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1521244800000",
    "number": "1801196134",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "176 LAKE AVE",
            "city": "SARATOGA SPRINGS",
            "state": "NY",
            "postal_code": "128662529",
            "telephone_number": "518-935-0068",
            "fax_number": "518-581-1145"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "176 LAKE AVE",
            "city": "SARATOGA SPRINGS",
            "state": "NY",
            "postal_code": "128662529",
            "telephone_number": "518-935-0068",
            "fax_number": "518-581-1145"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "28 Clinton St Ste 7",
            "address_purpose": "LOCATION",
            "city": "Saratoga Springs",
            "state": "NY",
            "postal_code": "128662143",
            "country_code": "US",
            "telephone_number": "518-935-0068",
            "fax_number": "518-306-5112",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "LAKE DENTAL OF SARATOGA, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-11-03",
        "last_updated": "2018-03-17",
        "status": "A",
        "authorized_official_last_name": "DENNIS",
        "authorized_official_first_name": "TRACIE",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "BOOK KEEPER",
        "authorized_official_telephone_number": "518-817-2490",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "052845",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "022051-1",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1710943774",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1467654178",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Brianna La Plant, RN
• Tammy J Labrake, LCSW
• Peter C. Lacy, LCSW
• Theodoros Laddis, MD
• Kathrin Lafaver, MD
• Jennifer Joye Lamb, PHARM. D
• Nikolas Lamphear, DPT
• Laramic Medical Group, P.a.
• Joseph M Larosa, MD
• Lauren Marie Larrabee, LMHC

• General Practice Dentistry in Saratoga Springs, NY
• Providers in Saratoga Springs, NY by specialty
• General Practice Dentistry in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.