JACOB S LAKE DDS LTD (NPI# 1134389208) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1134389208 |
| Entity Type | Organization |
| Organization Name | JACOB S LAKE DDS LTD |
| Practice Address |
15 E Dundee Rd Buffalo Grove IL 60089-4383 |
| Mailing Address |
15 E. Dundee Rd Buffalo Grove IL 60089 |
| Practice Telephone | 8472291700 |
| Practice Fax Number | 8472291737 |
| Mailing Telephone | 8472291700 |
| Mailing Fax Number | 8472291737 |
| Enumeration Date | 2008-06-12 |
| Last Update Date | 2011-12-30 |
| Authorized Official Name | JACOB S LAKE (OWNER) |
| Authorized Official Telephone | 8472291700 |
| Authorized Official Credential | DDS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
019016208 | IL | Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | 109096 | 05 | |
| IL | 104857 | 05 | |
| IL | 105622 | 05 | |
| IL | 105621 | 05 | |
| IL | 105875 | 05 | |
| IL | 197950 | 05 |
| Street Address |
15 E DUNDEE RD |
| City | BUFFALO GROVE |
| State | IL |
| Zip Code | 60089-4383 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780122465 | O Semeny Dds Ltd | Dentist | 15 E Dundee Rd, Buffalo Grove, IL 60089-4383 | 2017-02-02 |
| 1154872174 | Yevgen Tkachuk Dds PC | Dentist | 15 E Dundee Rd, Buffalo Grove, IL 60089-4383 | 2016-10-14 |
| 1063852325 | Kubra Atici | Dentist | 15 E Dundee Rd, Buffalo Grove, IL 60089-4383 | 2013-07-01 |
| 1881920536 | Michael Gelb Dds | Dentist | 15 E Dundee Rd, Buffalo Grove, IL 60089-4383 | 2009-10-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841795275 | Mary Elizabeth Strain, Phd LLC | Psychologist | 355 W Dundee Rd Ste 214, Buffalo Grove, IL 60089 | 2018-03-27 |
| 1861906067 | Pdi Medical IIi LLC | Pharmacy | 1623 Barclay Boulevard, Buffalo Grove, IL 60089 | 2017-11-27 |
| 1487165304 | Crystalann Sasha Thomas | Social Worker | 135 N Arlington Heights Rd., 104, Buffalo Grove, IL 60089 | 2017-10-18 |
| 1801315718 | Natalya Sagalov | Psychologist | 1283 Sandhurst Drive, Buffalo Grove, IL 60089 | 2017-09-12 |
| 1770035859 | Transport Auto Inc | Non-emergency Medical Transport (VAN) | 456 Chicory Ln, Buffalo Grove, IL 60089 | 2016-10-25 |
| 1982062535 | Eileen Fang | Occupational Therapist | 858 Horatio Blvd., Buffalo Grove, IL 60089 | 2016-02-10 |
| 1437538345 | Jamie Levin | Social Worker | 830 Belmar Lane, Buffalo Grove, IL 60089 | 2015-05-26 |
| 1669850756 | Cress Chiropractic Inc | Chiropractor | 1176 Mchenry Road, Buffalo Grove, IL 60089 | 2015-05-11 |
| 1801273123 | Vicki Lane Sheehan | Dentist | 2100 Lake Cook Rd., Suite 1100, Buffalo Grove, IL 60089 | 2015-05-06 |
| 1073918629 | Natalya Nagornaya Dds PC | Dentist | 472 Half Day Rd, Buffalo Grove, IL 60089 | 2014-10-24 |
| Find all providers in zip 60089 | ||||
| Taxonomy Code | 1223G0001X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | General Practice |
| A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. |
| Notes: Source: Academy of General Dentistry |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609438464 | Dental Health Professionals of Illinois, P.C. | Dentist | 1431 Mchenry Rd Ste 108, Buffalo Grove, IL 60089-1378 | 2019-07-02 |
| 1396290045 | Meghana Prabha | Dentist | 2568 Waterbury Ln, Buffalo Grove, IL 60089-6891 | 2016-08-23 |
| 1770950081 | Heng Xu | Dentist | 255 Willow Pkwy, Buffalo Grove, IL 60089-4639 | 2015-08-24 |
| 1073918629 | Natalya Nagornaya Dds PC | Dentist | 472 Half Day Rd, Buffalo Grove, IL 60089 | 2014-10-24 |
| 1003176561 | Scott Vukovich | Dentist | 1501 W Dundee Rd Ste 105, Buffalo Grove, IL 60089-4006 | 2012-05-17 |
| 1780853952 | Prashant C Patel | Dentist | 150 W Half Day Road, Ste 203, Buffalo Grove, IL 60089-6591 | 2008-02-21 |
| 1528240025 | Arbor Dental Group, P.C. | Dentist | 150 W Half Day Rd Ste 203, Buffalo Grove, IL 60089-6591 | 2007-11-27 |
| 1033237813 | Sam Mudrik | Dentist | 317 W Dundee Rd, Buffalo Grove, IL 60089-3545 | 2007-03-27 |
| 1275683575 | John D Kazanowski | Dentist | 1161 Mchenry Rd, Suite #201, Buffalo Grove, IL 60089-1373 | 2007-01-11 |
| 1609938091 | Dr Dennis A Lind PC | Dentist | 1501 W Dundee, Buffalo Grove, IL 60089 | 2006-12-14 |
| Find all providers in BUFFALO GROVE | ||||
| City | BUFFALO GROVE |
| Zip Code | 60089 |
Please comment or provide details below to improve the information on JACOB S LAKE DDS LTD.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.