Active NPIIndividual providerSole proprietor

Dr. Ryan J Lake, DMD

Dentist, General Practice in Clark, New Jersey

NPI Number1356462733
Practice location
246 Westfield Ave, Clark, NJ 07066-1537
Fax
732-381-8056
Last updated
July 8, 2007

Ryan J Lake is a Dentist, General Practice based in Clark, NJ. Ryan J Lake practices in Clark, NJ and has the professional credentials of DMD. The NPI Number for Ryan J Lake is 1356462733 and holds a License No. 22DI01957300 (NJ). The current practice location address for Ryan J Lake is 246 Westfield Ave, Clark, NJ 07066-1537 and can be reached out via phone at 732-381-8231 and via fax at 732-381-8056.

Provider Profile Details

NPI Number
1356462733
Provider Name
Ryan J Lake
Credential
DMD
Provider Entity Type
Individual
Gender
Male
Address
246 Westfield Ave, Clark, NJ 07066-1537
Phone Number
732-381-8231
Fax Number
732-381-8056
Primary Taxonomy
Dentist, General Practice · 1223G0001X
Sole Proprietor
Yes
Provider Enumeration Date
April 3, 2007
Last Update Date
July 8, 2007
NPI Status
Active

Provider Business Practice Location Address Details

Address
246 Westfield Ave
Clark, NJ 07066-1537
City
Clark
Zip
07066-1537
Phone Number
732-381-8231
Fax Number
732-381-8056
Clark, NJ 07066Get directions →

Provider Business Mailing Address Details

Address
246 Westfield Ave
Clark, NJ 07066-1537
City
Clark
State
NJ
Zip
07066-1537
Phone Number
732-381-8231
Fax Number
732-381-8056

License Information

License Number
22DI01957300
License State
NJ
Taxonomy
Dentist, General Practice · 1223G0001X · Primary

Legacy Identifiers

IdentifierTypeStateIssuer
No legacy identifiers (Medicaid, Medicare or plan IDs) are on file for this provider.

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Frequently Asked Questions

What is the NPI number of Dr. Ryan J Lake, DMD?

The NPI number of Dr. Ryan J Lake, DMD is 1356462733. It was assigned on April 3, 2007 and is currently active in the NPPES registry.

What is the specialty of Dr. Ryan J Lake, DMD?

Dr. Ryan J Lake, DMD is registered under the primary taxonomy Dentist, General Practice (code 1223G0001X), licensed in NJ under license number 22DI01957300.

Where does Dr. Ryan J Lake, DMD practice?

The practice location is 246 Westfield Ave, Clark, NJ 07066-1537. The office can be reached at 732-381-8231 (phone) or 732-381-8056 (fax).

What is an NPI number?

A National Provider Identifier (NPI) is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). It is used in HIPAA standard transactions.

How do I verify this NPI record?

This record is sourced from the public NPPES NPI Registry maintained by CMS. You can confirm it by searching NPI 1356462733 directly on the NPPES registry website.

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