DR. KEVIN JOSEPH LAKE DMD
NPI 1083638399
Dentist in New Providence, NJ

Active since July 27, 2006Opted out of Medicare · through Apr 19, 2028
5 ETHAN DR, NEW PROVIDENCE, NJ 07974(908) 464-5270 Get Directions Write a Review

NPPES record last updated: July 8, 2007. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Dr. Kevin Joseph Lake Dmd NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. KEVIN JOSEPH LAKE DMD (NPI 1083638399) is an individual dentist in New Providence, New Jersey, licensed in New Jersey (22DI02044100) and active in the NPI registry since July 2006. He has opted out of Medicare through April 19, 2028 and remains eligible to order and refer.

NPPES Registry Identity

NPI1083638399
Entity TypeIndividualMale
Primary Taxonomy122300000X
Provider Legal NameDR. KEVIN JOSEPH LAKECredential: DMD
Location Address5 ETHAN DRNew Providence, NJ 07974-1604
Mailing Address5 Ethan DrNew Providence, NJ 07974-1604 · (908) 464-5270
Sole ProprietorYes
Enumeration DateJuly 27, 2006
Last NPPES UpdateJuly 8, 2007
NPI 1083638399 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyDentistDental Providers
Taxonomy Code122300000X
License Licensed in NJ · 22DI02044100
Definition

A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist.

5 ETHAN DR, New Providence, NJ 07974

Accepted Insurance

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Opted out of Medicare

Dr. Kevin Joseph Lake Dmd has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from April 19, 2016 through April 19, 2028.

Opt-Out Effective DateApril 19, 2016
Opt-Out In Effect ThroughApril 19, 2028Opt-out affidavits renew automatically every two years unless cancelled
Eligible to Order & Refer Part B Labs & Imaging Durable Medical Equipment Home Health Agency Power Mobility DevicesAn opted-out provider can still order and refer for Medicare patients in the categories marked above, even though their own services are not covered.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 07974 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$98.09 typical visit price
range $63.84 – $190.92
Typical copayment $24.52 (range $15.96 – $47.73)
Most-billed visit code 99203
Established Patient
$79.09 typical visit price
range $20.97 – $155.92
Typical copayment $19.77 (range $5.24 – $38.98)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Kevin Lake's NPI number?

The NPI number for Kevin Lake is 1083638399. It was assigned to this individual provider in the NPPES registry on July 27, 2006.

Where is Kevin Lake located?

Kevin Lake practices at 5 Ethan Dr, New Providence, NJ 07974. The listed phone number is (908) 464-5270.

What is Kevin Lake's specialty?

The primary specialty registered for this NPI is Dentist with taxonomy code 122300000X.

Is Kevin Lake enrolled in Medicare?

No. Kevin Lake has opted out of Medicare through April 19, 2028. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out. The provider remains eligible to order and refer services for Medicare patients.

What insurance does Kevin Lake accept?

Health plans from Humana list Kevin Lake as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Kevin Lake was last updated on July 8, 2007. NPI Profile syncs with the weekly NPPES data releases published by CMS.