Active NPI
Lisa J Christy, D.D.S.
- Dentist
- Bridgman, MI
National Provider Identifier
1073676417
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 2901018067
- Practice address
- 9500 Red Arrow Hwy
Bridgman, MI 49106-9593 - Phone
- (269) 465-3001
- Fax
- (269) 465-3001
- NPI assigned
- Dec 18, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 2901018067 | MI | Primary |
Addresses
Primary practice location
9500 Red Arrow Hwy
Bridgman, MI 49106-9593
Mailing address
PO Box 748
9500 Red Arrow Highway
Bridgman, MI 49106-0748
Phone (269) 465-3001
Medicare participation
Medicare enrollment files- 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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20150819007851 | MI | Order and Referring Only - Dentist | 6507171527 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2901018067 | MI | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Buck'S Treasure PLLC | Dentist | Current | Accepting new patients |
Organizations & group practices 1
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.
-
- Dentist
- Bridgman, MI
- NPI 1528290889
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1166400000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1708560000000",
"number": "1073676417",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 748",
"address_2": "9500 RED ARROW HIGHWAY",
"city": "BRIDGMAN",
"state": "MI",
"postal_code": "491060748",
"telephone_number": "269-465-3001",
"fax_number": "269-465-3001"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9500 RED ARROW HWY",
"city": "BRIDGMAN",
"state": "MI",
"postal_code": "491069593",
"telephone_number": "269-465-3001",
"fax_number": "269-465-3001"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHRISTY",
"first_name": "LISA",
"middle_name": "J",
"credential": "D.D.S.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-12-18",
"last_updated": "2024-02-22",
"certification_date": "2024-02-22",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "MI",
"license": "2901018067",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bridgman, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2024; 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.