Matthew T. Lubbers, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

18172 Issued in MI

Practice address

1895 Georgetown Center Dr
Jenison, MI 49428-7137

Phone

(616) 988-2419

Fax

(616) 457-1148

NPI assigned

Nov 14, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

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

{
    "created_epoch": "1163462400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1386716462",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1895 GEORGETOWN CENTER DR",
            "city": "JENISON",
            "state": "MI",
            "postal_code": "494287137",
            "telephone_number": "616-988-2419",
            "fax_number": "616-457-1148"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1895 GEORGETOWN CENTER DR",
            "city": "JENISON",
            "state": "MI",
            "postal_code": "494287137",
            "telephone_number": "616-988-2419",
            "fax_number": "616-457-1148"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUBBERS",
        "first_name": "MATTHEW",
        "middle_name": "T.",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-14",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "18172",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Allison Liao, PHARMD
• Lifetime Eyecare P C
• Logan C Smith DDS PLLC (Smith Dental Team)
• Chantel Lokers
• Lea Jade Louie
• Cynthia Lucas, LMSW
• Jay Allen Lugthart, M.D.
• Chase G Lunde
• Lauren Jennifer Lyon, PT, DPT
• Joshua Marion

• General Practice Dentistry in Jenison, MI
• Providers in Jenison, 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.