Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1255865952 Individual Practitioner Female Practitioner

Dr. Stephanie Ann Lake , DO

Pediatrics • Dayton, OH

Professional Overview & Biography Verified Profile Summary

Dr. Stephanie Lake, DO is a registered healthcare professional specializing in Pediatrics in Dayton, OH. Practice services are available at 1816 HARVARD BLVD under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

1816 Harvard Blvd

Dayton, OH 454064543

Telephone 9376414000
Fax 9376414500
Associated Practice Facility / Clinic

Specialty Benchmarks & Practice Insights

Comparative analytics for Pediatrics in Dayton, OH

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 25.7 Yrs
State Avg: 20.0 Yrs
Regional Practice Density
66 Specialists

Practicing in Dayton, OH (3057 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

CMS Verified: 2026-02-13
Pediatrics Primary Specialty

NUCC Taxonomy Code: 208000000X

State License OH 34.013785

A pediatrician 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.

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID
0226309 (OH)

Secondary Practice Locations

1 Childrens Plz

Dayton, OH 454041815

Phone: 9376413600

171 Deeds Park Dr

Dayton, OH 454042699

Phone: 9378001235

8501 Old Troy Pike

Huber Heights, OH 454241054

Phone: 9376414360

3333 W Tech Rd

Miamisburg, OH 453420955

Phone: 9376415725

1010 Valley St

Dayton, OH 454042070

Phone: 9376414000

1711 Germantown Pike

Dayton, OH 45417

Phone: 9376413142

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

40 Associated Practitioners
NPI 1003808007

Doctor of Medicine (M.D.)

Dr. Ramakrishna Mutyala , MD

Pediatrics - Pediatric Gastroenterology

NPI 1013194802

Doctor of Medicine (M.D.)

Seth Kidwell , MSN, FNP-BC

Nurse Practitioner - Family

NPI 1033533484

Master of Science in Nursing, Family Nurse Practitioner (Board Certified)

Dr. Caitlyn Mccomb , MD

Pediatrics - Pediatric Hematology-Oncology

NPI 1033606017

Doctor of Medicine (M.D.)

Savana Howard , MS, NNP-BC

Nurse Practitioner - Neonatal, Critical Care

NPI 1033675962

Master of Science, NNPBC

Lori Milliron , CPNP

Nurse Practitioner - Pediatrics

NPI 1043410830

Certified Pediatric Nurse Practitioner

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

14 Historical Events
📍
Updated Business Mailing Address October 13, 2023

Registered at PO BOX 933432, CLEVELAND, OH 441930039 (Tel: 9376413000)

👤
Provider Name / Credentials Updated February 13, 2023

Recorded as STEPHANIE LAKE, DO

📍
Updated Practice Location September 13, 2021

Registered at 1816 HARVARD BLVD, DAYTON, OH 454064543 (Tel: 9376414000)

📍
Updated Practice Location January 13, 2021

Registered at 8501 OLD TROY PIKE, HUBER HEIGHTS, OH 454241054 (Tel: 9376414360)

📍
Updated Practice Location December 30, 2020

Registered at 3333 W TECH RD, MIAMISBURG, OH 453420955 (Tel: 9376415725)

📍
Updated Business Mailing Address December 30, 2020

Registered at 1 CHILDRENS PLZ, DAYTON, OH 454041815 (Tel: 9376413000)

👤
Provider Name / Credentials Updated December 30, 2020

Recorded as STEPHANIE WEBER, DO

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) December 30, 2020

Pediatrics (License #34.013785 in OH)

NPI Profile Active April 19, 2017

NPI status registered as active in NPPES database

📍
Updated Practice Location April 19, 2017

Registered at 1 CHILDRENS PLZ, MED ED DEPT, DAYTON, OH 454041873 (Tel: 9376413433)

📍
Updated Business Mailing Address April 19, 2017

Registered at 1 CHILDRENS PLZ, MED ED DEPT, DAYTON, OH 454041873

👤
Provider Name / Credentials Updated April 19, 2017

Recorded as STEPHANIE WEBER

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) April 19, 2017

Student in an Organized Health Care Education/Training Program

🟢
Initial NPI Registration & Enumeration April 19, 2017

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1255865952
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: April 19, 2017
Last Update: February 13, 2026
Sole Proprietor: No

Mailing Address

Po Box 933432

Cleveland, OH 441930039

Phone: 9376413000

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.