Individual provider Active NPI

Dennis Albert Engstrom, D.D.S.

  • Dentist
  • East Lansing, MI
National Provider Identifier
1003297359
Registry record updated Jun 12, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
2901021549 Issued in MI
Practice address
1451 E Lansing Dr
Suite 225
East Lansing, MI 48823-7785
Phone
(517) 332-8877
Fax
(517) 332-8848
NPI assigned
Jun 12, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 12, 2015

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 2901021549 MI Primary

Addresses

Primary practice location

1451 E Lansing Dr
Suite 225
East Lansing, MI 48823-7785

Mailing address

1451 E Lansing Dr
Suite 225
East Lansing, MI 48823-7785
Phone (517) 332-8877

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
2901021549MIMDDentist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1434067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1434067200000",
    "number": "1003297359",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1451 E LANSING DR",
            "address_2": "SUITE 225",
            "city": "EAST LANSING",
            "state": "MI",
            "postal_code": "488237785",
            "telephone_number": "517-332-8877",
            "fax_number": "517-332-8848"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1451 E LANSING DR",
            "address_2": "SUITE 225",
            "city": "EAST LANSING",
            "state": "MI",
            "postal_code": "488237785",
            "telephone_number": "517-332-8877",
            "fax_number": "517-332-8848"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ENGSTROM",
        "first_name": "DENNIS",
        "middle_name": "ALBERT",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-06-12",
        "last_updated": "2015-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MI",
            "license": "2901021549",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Lansing, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.