NPIMap

Organization Active NPI

Lakeview Dental Associates

  • General Practice Dentistry
  • Lakeview, MI
National Provider Identifier
1407006281
Registry record updated Sep 29, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
9226 Issued in MI
Legal business name
LAKEVIEW DENTAL ASSOCIATES
Practice address
924 S Lincoln Ave
Lakeview, MI 48850-9174
Phone
(989) 352-7294
Fax
(989) 352-8348
NPI assigned
Sep 29, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 29, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mrs. Susan Dianne Draper
Title
Office Manager
Phone
(989) 352-7294

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223G0001X 9226 MI Primary
General Practice DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223G0001X 18409 MI

Addresses

Primary practice location

924 S Lincoln Ave
Lakeview, MI 48850-9174

Mailing address

924 S Lincoln Ave
PO Box 530
Lakeview, MI 48850-9174
Phone (989) 352-7294

Other identifiers 6

IdentifierTypeStateIssuer
D092260OtherMIBC BS DENTAL
195597120OtherMIBCBS MEDICAL
1955910090OtherMIBCBS MEDICAL
124494419MedicaidMI
4006325MedicaidMI
D184090OtherMIBCBS DENTAL

National Provider Directory

National Provider Directory

Locations

924 S Lincoln Ave
Lakeview, MI 48850
Phone (989) 352-6477

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1222646400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1222646400000",
    "number": "1407006281",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "924 S LINCOLN AVE",
            "address_2": "PO BOX 530",
            "city": "LAKEVIEW",
            "state": "MI",
            "postal_code": "488509174",
            "telephone_number": "989-352-7294",
            "fax_number": "989-352-8348"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "924 S LINCOLN AVE",
            "city": "LAKEVIEW",
            "state": "MI",
            "postal_code": "488509174",
            "telephone_number": "989-352-7294",
            "fax_number": "989-352-8348"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKEVIEW DENTAL ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-09-29",
        "last_updated": "2008-09-29",
        "status": "A",
        "authorized_official_last_name": "DRAPER",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_middle_name": "DIANNE",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "989-352-7294",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "9226",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "18409",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC BS DENTAL",
            "identifier": "D092260",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS MEDICAL",
            "identifier": "195597120",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS MEDICAL",
            "identifier": "1955910090",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "124494419",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4006325",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS DENTAL",
            "identifier": "D184090",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakeview, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2008; 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.