Individual provider Active NPI

Michael Joseph Lattner, DDS MS

  • Prosthodontics
  • Dubuque, IA
National Provider Identifier
1346377983
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ProsthodonticsTaxonomy code 1223P0700X
License
07101 Issued in IA
Practice address
3480 Hillcrest Road
Dubuque, IA 52002-3877
Phone
(563) 583-3788
Fax
(563) 556-0508
NPI assigned
Feb 28, 2007
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
Prosthodontics 1223P0700X 07101 IA Primary

Addresses

Primary practice location

3480 Hillcrest Road
Dubuque, IA 52002-3877

Mailing address

3480 Hillcrest Road
Dubuque, IA 52002-3877
Phone (563) 583-3788

Other identifiers 1

IdentifierTypeStateIssuer
1200436MedicaidIA

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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
07101IAMDProsthodontist

Practice roles

OrganizationSpecialtyStatusNew patients
Applewhite Dental Iowa PC PastSince Nov 10, 2019 Accepting new patients
Applewhite Dental Iowa PC Prosthodontics Past Accepting new patients

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": "1172620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1346377983",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3480 HILLCREST ROAD",
            "city": "DUBUQUE",
            "state": "IA",
            "postal_code": "520023877",
            "telephone_number": "563-583-3788",
            "fax_number": "563-556-0508"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3480 HILLCREST ROAD",
            "city": "DUBUQUE",
            "state": "IA",
            "postal_code": "520023877",
            "telephone_number": "563-583-3788",
            "fax_number": "563-556-0508"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LATTNER",
        "first_name": "MICHAEL",
        "middle_name": "JOSEPH",
        "credential": "DDS MS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-28",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0700X",
            "taxonomy_group": "",
            "desc": "Dentist, Prosthodontics",
            "state": "IA",
            "license": "07101",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1200436",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dubuque, IA

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.