Individual provider Active NPI

Lisa Diane Baier, D.D.S.

  • General Practice Dentistry
  • Fenton, MI
National Provider Identifier
1386904050
Registry record updated Oct 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
2901020656 Issued in MI
Practice address
1535 N Leroy St Ste F
Fenton, MI 48430-2791
Phone
(810) 629-5454
NPI assigned
May 29, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 30, 2020

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 2901020656 MI Primary

Addresses

Primary practice location

1535 N Leroy St Ste F
Fenton, MI 48430-2791

Mailing address

213 W Rockwell St
Fenton, MI 48430-2078
Phone (810) 444-6069

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
I20160318001354 MI Order and Referring Only - DentistPractitioner - Dentist 4688971641

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2901020656MIMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
DCM Dentistry, PLC General Practice CurrentSince Nov 1, 2020 Accepting new patients
Fda PC PastSince Nov 1, 2020 Accepting new patients

Locations

1535 N Leroy St
Ste F
Fenton, MI 48430
Phone (810) 629-5454

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": "1338249600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604016000000",
    "number": "1386904050",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "213 W ROCKWELL ST",
            "city": "FENTON",
            "state": "MI",
            "postal_code": "484302078",
            "telephone_number": "810-444-6069"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1535 N LEROY ST STE F",
            "city": "FENTON",
            "state": "MI",
            "postal_code": "484302791",
            "telephone_number": "810-629-5454"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAIER",
        "first_name": "LISA",
        "middle_name": "DIANE",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-05-29",
        "last_updated": "2020-10-30",
        "certification_date": "2020-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "2901020656",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fenton, MI

Sources for this page

Verify at the official NPI Registry.