Active NPI
Karl Martin Lyngaas, D.D.S.
- Dentist
- Lincoln Park, MI
National Provider Identifier
1407948565
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 11596
- Practice address
- 3830 Fort Street
Lincoln Park, MI 48146 - Phone
- (313) 383-6800
- Fax
- (313) 383-1026
- NPI assigned
- Sep 28, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 11596 | MI | Primary |
Addresses
Primary practice location
3830 Fort Street
Lincoln Park, MI 48146
Mailing address
3830 Fort Street
Lincoln Park, MI 48146
Phone (313) 383-6800
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11596 | MI | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Downriver Dental Associates P.C. | Dentist | Past | Accepting new patients |
Organizations & group practices 1
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": "1159401600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1407948565",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3830 FORT STREET",
"city": "LINCOLN PARK",
"state": "MI",
"postal_code": "48146",
"telephone_number": "313-383-6800",
"fax_number": "313-383-1026"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3830 FORT STREET",
"city": "LINCOLN PARK",
"state": "MI",
"postal_code": "48146",
"telephone_number": "313-383-6800",
"fax_number": "313-383-1026"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LYNGAAS",
"first_name": "KARL",
"middle_name": "MARTIN",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-09-28",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "MI",
"license": "11596",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lincoln Park, MI
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.