Ulrich Lake, DDS

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

4288015 Issued in WI

Practice address

100 River Place
Ste 110
Madison, WI 53716

Phone

(608) 222-6160

Fax

(608) 222-6248

NPI assigned

Oct 12, 2006

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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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 and National Provider Directory roles.

• Madison Pediatric Dental, SC

  • Pediatric Dentistry
  • Madison, WI
  • NPI 1538230966
  NPD (past)

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

{
    "created_epoch": "1160611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1821187683",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 RIVER PLACE",
            "address_2": "STE 110",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "53716",
            "telephone_number": "608-222-6160",
            "fax_number": "608-222-6248"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 RIVER PLACE",
            "address_2": "STE 110",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "53716",
            "telephone_number": "608-222-6160",
            "fax_number": "608-222-6248"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAKE",
        "first_name": "ULRICH",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "WI",
            "license": "4288015",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "33762600",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jason Lai, M.D.
• Sarah Lai, PA-C
• Janet Lainhart, MD
• Lake Monona Psychotherapy & Recovery Center
• Elizabeth L Lake, M.D.
• Wendell Bradley Lake, M.D.
• Lakefront Medical Transportation LLC
• Lakeland Counseling and Assessment, LLC
• Lakeside Counseling Center, LLC
• Andreja B Lakic, CAA

• Pediatric Dentistry in Madison, WI
• Providers in Madison, WI by specialty
• Pediatric Dentistry in Wisconsin

• 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.