Individual provider Active NPI

Bernard A Labombard, DDS

  • General Practice Dentistry
  • Bay City, MI
National Provider Identifier
1174615249
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
17945 Issued in MI
Practice address
1012 Lafayette
Bay City, MI 48708
Phone
(989) 893-5711
Fax
(989) 893-5854
NPI assigned
Sep 28, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 17945 MI Primary

Addresses

Primary practice location

1012 Lafayette
Bay City, MI 48708

Mailing address

1012 Lafayette
Bay City, MI 48708
Phone (989) 893-5711

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160119000915 MI Order and Referring Only - DentistPractitioner - Dentist 9739482126

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
17945MIMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Bernard Labombard DDS PLC General Practice CurrentSince Feb 26, 2023 Accepting new patients
Great Lakes Family Dental Group - Bay City PC General Practice Past Accepting new patients

Locations

1012 Lafayette Ave
Bay City, MI 48708
Phone (989) 893-5711

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1159401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1174615249",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1012 LAFAYETTE",
            "city": "BAY CITY",
            "state": "MI",
            "postal_code": "48708",
            "telephone_number": "989-893-5711",
            "fax_number": "989-893-5854"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1012 LAFAYETTE",
            "city": "BAY CITY",
            "state": "MI",
            "postal_code": "48708",
            "telephone_number": "989-893-5711",
            "fax_number": "989-893-5854"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LABOMBARD",
        "first_name": "BERNARD",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-28",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "17945",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bay City, MI

Sources for this page

Verify at the official NPI Registry.