Daniel J. Derksen

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

2901019585 Issued in MI

Practice address

714 Abbott Rd
East Lansing, MI 48823-3101

Phone

(517) 337-0351

Fax

(517) 337-5610

NPI assigned

Jun 4, 2007

Last updated

Jul 8, 2007By the provider in NPPES

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

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Daniel J. Derksen, DDS, PLLC

  • General Practice Dentistry
  • Lansing, MI
  • NPI 1962752725
  NPD (past) Authorized official
• Craig a. Fedore,D.D.S., P.C.

  • General Practice Dentistry
  • East Lansing, MI
  • NPI 1972583334
  NPD (past)
• Tiggy Lazer, PLLC Dba East Lansing Family Dentistry

  • Dental Clinic/Center
  • East Lansing, MI
  • NPI 1942087127
  NPD (past)

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

{
    "created_epoch": "1180915200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1275735029",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "714 ABBOTT RD",
            "city": "EAST LANSING",
            "state": "MI",
            "postal_code": "488233101",
            "telephone_number": "517-337-0351",
            "fax_number": "517-337-5610"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "714 ABBOTT RD",
            "city": "EAST LANSING",
            "state": "MI",
            "postal_code": "488233101",
            "telephone_number": "517-337-0351",
            "fax_number": "517-337-5610"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DERKSEN",
        "first_name": "DANIEL",
        "middle_name": "J.",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-04",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "2901019585",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Robin Hazard Demuth, MD
• Carrie Alice Denbow, LMSW
• Jenna Deneka
• Sarah Jean Denham, DO
• Reid Depowski-Knowles, LMSW
• Jacqueline Derose
• Lisa Ann Destefano, D.O
• Maninder S Deswal, D.P.M.
• Stephanie Joy Deward, M.S.
• Diane Marie Dewey, OWNER/COLLECTOR

• General Practice Dentistry in East Lansing, MI
• Providers in East Lansing, MI by specialty
• General Practice Dentistry in Michigan

• 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.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.