Lincoln Park Dental Associates

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

11350 Issued in MI

Legal business name

LINCOLN PARK DENTAL ASSOCIATES

Practice address

3577 Fort St
Lincoln Park, MI 48146-4114

Phone

(313) 388-0103

Fax

(313) 388-3219

NPI assigned

Apr 15, 2008

Last updated

Apr 15, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Anthony Wayne Stines, D.D.S.NPI 1124166459

Title

President

Phone

(313) 388-0103

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Anthony Wayne Stines, DDS

  • General Practice Dentistry
  • Lincoln Park, MI
  • NPI 1124166459
  NPD (past) Authorized official

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

{
    "created_epoch": "1208217600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208217600000",
    "number": "1033383716",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3577 FORT ST",
            "city": "LINCOLN PARK",
            "state": "MI",
            "postal_code": "481464114",
            "telephone_number": "313-388-0103",
            "fax_number": "313-388-3219"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3577 FORT ST",
            "city": "LINCOLN PARK",
            "state": "MI",
            "postal_code": "481464114",
            "telephone_number": "313-388-0103",
            "fax_number": "313-388-3219"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LINCOLN PARK DENTAL ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-15",
        "last_updated": "2008-04-15",
        "status": "A",
        "authorized_official_last_name": "STINES",
        "authorized_official_first_name": "ANTHONY",
        "authorized_official_middle_name": "WAYNE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "313-388-0103",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "11350",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• John Lewis, L.M.S.W.
• Lifeline Concord LLC
• Lifesmart Medical Center PLLC
• Lifesmart Pharmacy LLC
• Lincoln DME Care Supply LLC
• Lincoln Park Family Dentistry DDS PC
• Lincoln Park Health Management
• Lincoln Park Kidney Center LLC
• Lincoln Park Pharmacy LLC (PharMor Pharmacy- Lincoln Park)
• Lincoln Park Rehabilitation PC

• General Practice Dentistry in Lincoln Park, MI
• Providers in Lincoln Park, MI by specialty
• General Practice Dentistry in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2008; 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.