Active NPI
Bobby R Echols, DDS
- Dentist
- Lapeer, MI
National Provider Identifier
1104919299
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 12215
- Practice address
- 3225 John Conley Dr
Thumb Correctional Facility
Lapeer, MI 48446-2987 - Phone
- (810) 667-2045
- Fax
- (810) 667-6732
- NPI assigned
- Oct 2, 2006
- Sex
- Male
- Sole proprietor
- No
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 | 12215 | MI | Primary |
Addresses
Primary practice location
3225 John Conley Dr
Thumb Correctional Facility
Lapeer, MI 48446-2987
Mailing address
22200 W 11 Mile Rd Unit 238
Southfield, MI 48037-7009
Phone (248) 388-8408
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
| License | State | Type | Specialty |
|---|---|---|---|
| 12215 | MI | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159747200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1445212800000",
"number": "1104919299",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "22200 W 11 MILE RD UNIT 238",
"city": "SOUTHFIELD",
"state": "MI",
"postal_code": "480377009",
"telephone_number": "248-388-8408"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3225 JOHN CONLEY DR",
"address_2": "THUMB CORRECTIONAL FACILITY",
"city": "LAPEER",
"state": "MI",
"postal_code": "484462987",
"telephone_number": "810-667-2045",
"fax_number": "810-667-6732"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ECHOLS",
"first_name": "BOBBY",
"middle_name": "R",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-02",
"last_updated": "2015-10-19",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "MI",
"license": "12215",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lapeer, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 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.