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LAKE DENTISTRY, LLC
NPI 1376608992
Dentist - General Practice in St. Matthews, SC

Active since December 26, 2006
735 RAYSOR DRIVE, ST. MATTHEWS, SC 29135(803) 874-2243 Get Directions Write a Review

NPPES record last updated: January 10, 2008. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Lake Dentistry, Llc NPPES

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

LAKE DENTISTRY, LLC (NPI 1376608992) is a healthcare organization registered as a general practice in St. Matthews, South Carolina and active in the NPI registry since December 2006. The organization lists Clarence R Lake, Partner, as its authorized official.

NPPES Registry Identity

NPI1376608992
Entity TypeOrganization
Primary Taxonomy1223G0001X
Legal Business NameLAKE DENTISTRY, LLC
Location Address735 RAYSOR DRIVESt. Matthews, SC 29135
Mailing Address735 Raysor DriveSt. Matthews, SC 29135 · (803) 874-2243
Phone(803) 874-2243
Organization SubpartNo
Authorized OfficialClarence R LakePartner · (803) 874-2243
Enumeration DateDecember 26, 2006
Last NPPES UpdateJanuary 10, 2008
✔ NPI 1376608992 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · General PracticeDental Providers
Taxonomy Code1223G0001X
Definition
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.
735 RAYSOR DRIVE, St. Matthews, SC 29135
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Other Identifiers 1

MedicaidZA9868SC

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. CLARENCE ROBERTS LAKE D.M.D.
Dentist (General Practice)
735 RAYSOR DRIVE
ST. MATTHEWS, SC 29135
Calhoun County (803) 874-2243

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 Lake Dentistry, LLC's NPI number?

The NPI number for Lake Dentistry, LLC is 1376608992. It was assigned to this organization in the NPPES registry on December 26, 2006.

Where is Lake Dentistry, LLC located?

Lake Dentistry, LLC is located at 735 Raysor Drive, St. Matthews, SC 29135. The listed phone number is (803) 874-2243.

What is Lake Dentistry, LLC's specialty?

The primary specialty registered for this NPI is Dentist, specializing in General Practice, with taxonomy code 1223G0001X.

When was this NPI record last updated?

The NPPES record for Lake Dentistry, LLC was last updated on January 10, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.