Cavanaugh Dental PLLC

Primary specialty

DentistTaxonomy code 122300000X

Legal business name

CAVANAUGH DENTAL PLLC

Practice address

900 E Cavanaugh Rd
Lansing, MI 48910-5624

Phone

(517) 371-5374

NPI assigned

Feb 13, 2019

Organization subpart

No

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

Authorized official

Name

Dr. Daniel J. Derksen, DDS

Title

Member

Phone

(517) 371-5342

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1550016000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1550016000000",
    "number": "1124584396",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2410 LAKE LANSING RD STE 2",
            "city": "LANSING",
            "state": "MI",
            "postal_code": "489123659",
            "telephone_number": "517-371-5342"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 E CAVANAUGH RD",
            "city": "LANSING",
            "state": "MI",
            "postal_code": "489105624",
            "telephone_number": "517-371-5374"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAVANAUGH DENTAL PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-02-13",
        "last_updated": "2019-02-13",
        "status": "A",
        "authorized_official_last_name": "DERKSEN",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_middle_name": "J.",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "517-371-5342",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Dentist in Lansing, MI
• Providers in Lansing, MI by specialty
• Dentist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2019; 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.