NPIMap

Organization Active NPI

Hagan Rodriguez Periodontics & Implants

  • Periodontics
  • East Lansing, MI
National Provider Identifier
1093872525
Registry record updated Jan 31, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
PeriodonticsTaxonomy code 1223P0300X
License
17100 Issued in MI
Legal business name
HAGAN RODRIGUEZ PERIODONTICS & IMPLANTS
Practice address
335 W Lake Lansing Rd Ste 100
East Lansing, MI 48823-8486
Phone
(517) 336-9880
Fax
(517) 336-9881
NPI assigned
Jan 3, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 31, 2023

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

Authorized official

Name
Lisa Lynn Vermillion
Title
Office Manager
Phone
(517) 336-9880

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PeriodonticsGroup: 193400000X SINGLE SPECIALTY GROUP 1223P0300X 17100 MI Primary

Addresses

Primary practice location

335 W Lake Lansing Rd Ste 100
East Lansing, MI 48823-8486

Mailing address

335 W Lake Lansing Rd Ste 100
East Lansing, MI 48823-8486
Phone (517) 336-9880

National Provider Directory

National Provider Directory

Locations

335 W Lake Lansing Rd
Ste 100
East Lansing, MI 48823
Phone (517) 336-9880

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1167782400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1675123200000",
    "number": "1093872525",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "335 W LAKE LANSING RD STE 100",
            "city": "EAST LANSING",
            "state": "MI",
            "postal_code": "488238486",
            "telephone_number": "517-336-9880",
            "fax_number": "517-336-9881"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "335 W LAKE LANSING RD STE 100",
            "city": "EAST LANSING",
            "state": "MI",
            "postal_code": "488238486",
            "telephone_number": "517-336-9880",
            "fax_number": "517-336-9881"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HAGAN RODRIGUEZ PERIODONTICS & IMPLANTS",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-03",
        "last_updated": "2023-01-31",
        "certification_date": "2023-01-31",
        "status": "A",
        "authorized_official_last_name": "VERMILLION",
        "authorized_official_first_name": "LISA",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "517-336-9880"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Periodontics",
            "state": "MI",
            "license": "17100",
            "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 Jan 31, 2023; 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.