Michel Jahmal Lundy, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

2901600380 Issued in MI

Practice address

5695 Dixie Hwy
Waterford TWP, MI 48329-1619

Phone

(248) 707-3650

NPI assigned

Jun 4, 2019

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Waterford Family Dental PLLC

  • Dental Clinic/Center
  • Waterford, MI
  • NPI 1306454723
  NPD

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

{
    "created_epoch": "1559606400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1592784000000",
    "number": "1043878010",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5695 DIXIE HWY",
            "city": "WATERFORD TWP",
            "state": "MI",
            "postal_code": "483291619",
            "telephone_number": "509-868-3166"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5695 DIXIE HWY",
            "city": "WATERFORD TWP",
            "state": "MI",
            "postal_code": "483291619",
            "telephone_number": "248-707-3650"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUNDY",
        "first_name": "MICHEL",
        "middle_name": "JAHMAL",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-06-04",
        "last_updated": "2020-06-22",
        "certification_date": "2020-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "2901600380",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dental House - Waterford, PLLC
• Kelli Ford
• Sara Helmi
• Jason B Ingber, DDS
• Chase A Lundin, DDS
• Thanh Huu Phan, MD

• General Practice Dentistry in Waterford TWP, MI
• Providers in Waterford TWP, 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 Jun 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.