Jacob S Lake Dds Ltd

LBN: Jacob S Lake Dds Ltd
Jacob S Lake Dds Ltd is an health care organization with primary practice located at 15 E Dundee Rd , Buffalo Grove IL 60089-4383. The organization recently has only one registered license in Dental Providers / General Practice, which is considered as the primary health care specialty. Jacob S Lake Dds Ltd can be contacted via phone (847) 229-1700, or through Lake, Jacob S via phone (847) 229-1700.

Contact Information

Primary practice address
15 E Dundee Rd Buffalo Grove IL 60089-4383
Phone: (847) 229-1700
Fax: (847) 229-1737
Website:
Map and Directions
Authorized official contact:
Name: Lake, Jacob S Doctor of Dental Surgery (DDS)
Phone: (847) 229-1700

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / General Practice 1223G0001X 019016208 Illinois

Profile Details

NPI number 1134389208
LBN Legal business name Jacob S Lake Dds Ltd
DBA Doing business as
Authorized official Lake, Jacob S Doctor of Dental Surgery (DDS)
Entity Organization
Organization subpart 1 No
Enumeration date Jun 12th, 2008
Last updated Dec 30th, 2011 - about 13 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1134389208 NPPES
Illinois MEDICAID 197950
Illinois MEDICAID 105621
Illinois MEDICAID 104857
Illinois MEDICAID 109096
Illinois MEDICAID 105622
Illinois MEDICAID 105875

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