Individual provider Active NPI

Michael James Lawton, DDS

  • Dentist
  • New London, WI
National Provider Identifier
1275637803
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
2523 Issued in WI
Practice address
105 Northridge Dr
New London, WI 54961-2703
Phone
(920) 982-3567
Fax
(920) 982-0993
NPI assigned
Sep 12, 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
Dentist 122300000X 2523 WI Primary

Addresses

Primary practice location

105 Northridge Dr
New London, WI 54961-2703

Mailing address

PO Box 205
New London, WI 54961-0205
Phone (920) 982-3567

Other identifiers 1

IdentifierTypeStateIssuer
33428300MedicaidWI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
2523WIMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1158019200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1275637803",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 205",
            "city": "NEW LONDON",
            "state": "WI",
            "postal_code": "549610205",
            "telephone_number": "920-982-3567",
            "fax_number": "920-982-0993"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 NORTHRIDGE DR",
            "city": "NEW LONDON",
            "state": "WI",
            "postal_code": "549612703",
            "telephone_number": "920-982-3567",
            "fax_number": "920-982-0993"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAWTON",
        "first_name": "MICHAEL",
        "middle_name": "JAMES",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WI",
            "license": "2523",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "33428300",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New London, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.