Lino Sevandal Dial Jr., DO

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

5101014103 Issued in MI

Practice address

1101 S. Mission Street
Mt. Pleasant, MI 48858

Phone

(989) 773-9700

Fax

(989) 779-9701

NPI assigned

Oct 11, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. Confirm with the OIG exclusions search.

Credentials

Doctor of Osteopathy

Practice roles

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.

• Great Lakes Bay Health Centers

  dba Great Lakes Bay Health Centers Integrated Care Midland

  • Federally Qualified Health Center (FQHC)
  • Midland, MI
  • NPI 1609609536
  NPD (past)
• Great Lakes Bay Health Centers

  • Obstetrics & Gynecology Physician
  • Saginaw, MI
  • NPI 1871684761
  NPD (past)

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

{
    "created_epoch": "1128988800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1308700800000",
    "number": "1245228568",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5511 WEST U.S. HIGHWAY 10",
            "city": "LUDINGTON",
            "state": "MI",
            "postal_code": "49431",
            "telephone_number": "231-843-1553",
            "fax_number": "231-845-5515"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 S. MISSION STREET",
            "city": "MT. PLEASANT",
            "state": "MI",
            "postal_code": "48858",
            "telephone_number": "989-773-9700",
            "fax_number": "989-779-9701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIAL",
        "first_name": "LINO",
        "middle_name": "SEVANDAL",
        "name_suffix": "Jr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-11",
        "last_updated": "2011-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "5101014103",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP",
            "identifier": "0N85680",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1245228568",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS GROUP",
            "identifier": "700E310160",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Luke Denzer
• Paige Deruiter
• Saurabh H Desai, RPT
• Abbie Renae Dewitt, FNP-BC
• Kimber Dewitt, D.D.S., M.S.
• Dialysis Access Partners, PLLC
• Mary Frances Diepstra, MSW
• Gabrielle Digiovanni, P.A.
• Pamela Marie Dilno
• Dominique Hope Dimatteo

• Family Medicine Physician in Mt. Pleasant, MI
• Providers in Mt. Pleasant, MI by specialty
• Family Medicine Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; OIG LEIE.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.