Individual provider Active NPI

Landi Anne Heller, DDS

  • General Practice Dentistry
  • South Lyon, MI
National Provider Identifier
1245316595
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
14940 Issued in MI
Practice address
505 S Lafayette
South Lyon, MI 48178
Phone
(248) 437-2024
Fax
(248) 437-1924
NPI assigned
Oct 30, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
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 14940 MI Primary

Addresses

Primary practice location

505 S Lafayette
South Lyon, MI 48178

Mailing address

505 S Lafayette
South Lyon, MI 48178
Phone (248) 437-2024

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
I20161004000830 MI Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 9436447653

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
14940MIMDMusic Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Landi a Heller DDS General Practice Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1162166400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1245316595",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "505 S LAFAYETTE",
            "city": "SOUTH LYON",
            "state": "MI",
            "postal_code": "48178",
            "telephone_number": "248-437-2024",
            "fax_number": "248-437-1924"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "505 S LAFAYETTE",
            "city": "SOUTH LYON",
            "state": "MI",
            "postal_code": "48178",
            "telephone_number": "248-437-2024",
            "fax_number": "248-437-1924"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HELLER",
        "first_name": "LANDI",
        "middle_name": "ANNE",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-30",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "14940",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Lyon, MI

Sources for this page

Verify at the official NPI Registry.