Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Scott Lake, OD

Individual provider Optometrist · NPI 1154587822

Scott Lake, OD is an Optometrist in Glendale, Arizona. Licensed in Arizona and Connecticut. Registered with an NPI since 2008.

Licensed in
AZ, CT
In the registry since
2008
Specialties on file
2
What do these letters mean?
OD — Doctor of Optometry
An optometrist: examines eyes, prescribes glasses and contacts, and treats many eye conditions.

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Practice location Address checks out

5707 W Northern Ave Ste 106
Glendale, AZ 85301-1355
Phone: (602) 512-3299
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Optometrist (primary) Taxonomy 152W00000X · Licence 2519 (AZ)
Optometrist Taxonomy 152W00000X · Licence 002756 (CT)

Record details

NPI number1154587822
Entity typeIndividual (Type 1)
GenderMale
Credentials OD
Sole proprietorNo
NPI enumeratedAugust 1, 2008
Last updated in NPPESSeptember 21, 2021
Certification dateSeptember 21, 2021
Mailing address220 N McKemy Ave, Chandler, AZ 85226-2651

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