DR. JOHN CAMPBELL LAKE JR. (NPI# 1215263017) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1215263017 |
| Entity Type | Individual |
| Full Name | DR. JOHN CAMPBELL LAKE JR. |
| Credential | D.M.D. |
| Practice Address |
2706 Main St Newberry SC 29108-4004 |
| Practice Telephone | 8032762090 |
| Mailing Telephone | 8032762090 |
| Enumeration Date | 2009-10-29 |
| Last Update Date | 2016-04-18 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
4593 | SC | Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| SC | ZX4593 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629270194 | John T Lake | Psychiatry & Neurology | 60 Doctors Park Lowr Level, Cape Girardeau, MO 63703 | 2007-06-05 |
| 1619081031 | John F Lake | Dentist | 286 Sw 4th St, Ontario, OR 97914-2610 | 2006-08-19 |
| 1952326027 | John Roger Lake Jr. | Dentist | 1322 Main St, Osterville, MA 02655-1542 | 2006-07-12 |
| 1861561367 | John M Lake | Counselor | 165 E Hawthorne Ave, Colville, WA 99114-2629 | 2006-11-07 |
| 1740360619 | John Richard Lake | Internal Medicine | University of Minnesota Physicians, 516 Delaware Street Se, Clinic 2a, Minneapolis, MN 55454-1478 | 2006-10-16 |
| 1871607739 | John Steven Lake | Dentist | 345 Tachevah Dr, Ste 1, Palm Springs, CA 92262 | 2006-08-18 |
| 1780798645 | John Herbert Lake | Dentist | 345 Tachevah Dr, Suite 1, Palm Springs, CA 92262 | 2006-08-18 |
| 1568497238 | John Russell Lake | Orthopaedic Surgery | 5565 Grossmont Center Dr, Bldg 3 Suite 256, La Mesa, CA 91942-3020 | 2006-07-11 |
| Street Address |
2706 MAIN ST |
| City | NEWBERRY |
| State | SC |
| Zip Code | 29108-4004 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396794038 | James R Williams Jr. | Dentist | 2706 Main St, Newberry, SC 29108-4004 | 2006-05-09 |
| 1457898132 | Newberry Dental, PC | Dentist | 2706 Main St, Newberry, SC 29108-4004 | 2017-01-19 |
| 1619339645 | Newberry Dental Care | Dentist | 2706 Main St, Newberry, SC 29108-4004 | 2016-03-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104472109 | Palmetto Bone and Joint | Pain Medicine | Palmetto Bone and Joint, 2605 Kinard St Suite 105, Newberry, SC 29108 | 2019-08-15 |
| 1922578582 | Joni Seibert Chapman | Registered Nurse | 3419 Main Street, Newberry, SC 29108 | 2018-11-27 |
| 1235652967 | Stephanie M Fulmer | Nurse Practitioner | 2351 Evans Street, Suite A, Newberry, SC 29108 | 2017-07-25 |
| 1497152177 | Frances Diane Martin | Registered Nurse | 9307 Sc Highway 34, Newberry, SC 29108 | 2014-11-25 |
| 1528463254 | Lauren Flynn | Registered Nurse | 3419 Main St, Newberry, SC 29108 | 2014-10-23 |
| 1689017998 | Charlene Kneece | Registered Nurse | 255 Hawkins Road, Newberry, SC 29108 | 2013-04-17 |
| 1952642423 | Allison Kyzer Gardner | Chiropractor | 3218 College Street, Newberry, SC 29108 | 2013-03-08 |
| 1972853372 | Dipa Mcgee | Pharmacist | 1210 Wilson Road, Newberry, SC 29108 | 2012-09-12 |
| 1730339060 | Fresenius Medical Care Cna Kidney Centers, LLC | Clinic/Center | 2850 Kinard St, Newberry, SC 29108 | 2008-09-23 |
| 1508042201 | Newberry Oncology Associates | Radiology | 298 Commerce Dr., Newberry, SC 29108 | 2008-01-14 |
| Find all providers in zip 29108 | ||||
| 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 |
|---|---|---|---|---|
| 1306376512 | Sean Theron Williams | Dentist | 13576 Nw 2nd Ln Ste 30, Newberry, FL 32669-3736 | 2017-06-20 |
| 1619190246 | Robert P. Mccartha | Dentist | 2039 Medical Park Dr, Newberry, SC 29108-2249 | 2007-04-11 |
| 1316033376 | Willaim B. Rush | Dentist | 2306 Harrington St, Newberry, SC 29108-3028 | 2006-10-05 |
| 1396794038 | James R Williams Jr. | Dentist | 2706 Main St, Newberry, SC 29108-4004 | 2006-05-09 |
| 1538148374 | Erwin Renwick Baker | Dentist | 1307 Hunt St, Newberry, SC 29108-3035 | 2006-01-11 |
| 1447885173 | Diane Zybko Broom | Dentist | 2039 Medical Park Dr, Newberry, SC 29108-2249 | 2020-03-03 |
| 1245684778 | Bela Family Dentistry of Newberry | Dentist | 1335 Kinard St, Newberry, SC 29108-3037 | 2016-04-21 |
| 1619339645 | Newberry Dental Care | Dentist | 2706 Main St, Newberry, SC 29108-4004 | 2016-03-29 |
| 1528285970 | Eric Steven Laroue | Dentist | 501 W Harrie St, Newberry, MI 49868-1226 | 2007-04-19 |
| 1003973009 | Kevin Malcolm James | Dentist | 1108 Calhoun St, Newberry, SC 29108-3445 | 2007-01-02 |
| Find all providers in NEWBERRY | ||||
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| 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.