Dennis Lake
M.D. | Pediatrics | Male
Dennis Lake, M.D. is a Grand Rapids, Michigan based Pediatric doctor with medical specialization in
General Pediatrics.
Current practice location of Dennis Lake is
710 Kenmoor Ave Se, Suite 110, Grand Rapids, Michigan - 49546-2379. He can be contacted on phone at
616-949-6112 and fax number 616-949-8530.
Dennis Lake is a sole proprietor of his business.
NPI number (Unique professional ID) for Dennis Lake is
1700986205 which was assigned by NPPES on 24 Sep, 2006 and it was last updated on 08 Jul, 2007.
Dennis Lake license number is
4301039973 for Pediatrics (208000000X) in Michigan.
Dennis Lake is a pediatrician who is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.
Complete Profile:
Dennis Lake basic information including his official name, gender, specialization, credentials etc. are as mentioned below.
| Specialization : | Pediatrics |
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| Provider Name : | Dennis Lake |
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| Credential : | M.D. |
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| Gender : | Male |
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Business Address:
Dennis Lake address, contact phone number and fax are as below. Patients can directly walkin to the clinic or can call on the below given phone number for appointment.
| Primary Address : | 710 Kenmoor Ave Se, Suite 110
Grand Rapids, MI, 49546-2379
United States |
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| Phone Number : | 616-949-6112 |
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| Fax Number : | 616-949-8530 |
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Professional Identification Codes:
NPI number stands for National Provider Identifier which 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). NPI details are as mentioned below.
| NPI Number : | 1700986205 |
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| NPI Entity Type : | Individual |
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| First Enrolment Date : | 24 Sep, 2006 |
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| Last Updated On : | 08 Jul, 2007 |
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Licenses and Specialities:
Physicians/Organizations can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Dennis Lake are as mentioned. Primary taxonomy code for Dennis Lake, M.D. is
208000000X (Pediatrics).
| Taxonomy Code | Speciality | Primary | License No. | State |
|---|
| 208000000X | Pediatrics | Yes | 4301039973 | MI |
Legacy Identifiers:
Other legacy medical identifiers of Dennis Lake such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned below.
| Identifier | Identifier Type | State | Issuer |
|---|
| 2890360 | MEDICAID | MI | |
Mailing Address:
Mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned business address only.
| Mailing Address : | 710 Kenmoor Ave Se, Suite 110
Grand Rapids, MI, 49546-2379
United States |
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| Phone Number : | 616-949-6112 |
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| Fax Number : | 616-949-8530 |
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Business Location:
Patients can refer following map for directions to
Dennis Lake practice address. Don't forget to take prior appointment before visiting.
** Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on 08 January, 2024.