Lakeside Smiles, PLLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

13870 Issued in MI

Legal business name

LAKESIDE SMILES, PLLC

Practice address

200 N Maple St
Fennville, MI 49408-8478

Phone

(269) 561-2904

NPI assigned

Jan 16, 2015

Last updated

Jan 16, 2015By 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. Michael E Meyer, DDS

Title

Member

Phone

(269) 561-2904

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1421366400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1421366400000",
    "number": "1124417928",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 N MAPLE ST",
            "address_2": "PO BOX 506",
            "city": "FENNVILLE",
            "state": "MI",
            "postal_code": "494088478",
            "telephone_number": "269-561-2904"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 N MAPLE ST",
            "city": "FENNVILLE",
            "state": "MI",
            "postal_code": "494088478",
            "telephone_number": "269-561-2904"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKESIDE SMILES, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-01-16",
        "last_updated": "2015-01-16",
        "status": "A",
        "authorized_official_last_name": "MEYER",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "269-561-2904",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "13870",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Karing Conversations
• Kaitlyn Kelly, LLMSW
• Kenneth Earl Kratzer (Fennville Family Medicine)
• Curtis A. Lacy, L.P.C.
• Lakeshore Pharmacies, Inc (Alexander's Drug Store)
• Hugh Cameron Little Sr., P.T.
• McAp Fennville Opco LLC
• James Peter Motiff, PH.D.
• Jennifer L Rewa, OT
• Arthur H Rossof, MD

• General Practice Dentistry in Fennville, MI
• Providers in Fennville, 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 Jan 16, 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.

Verify at the official NPI Registry.