NPIMap

Organization Active NPI

Lifetime Dental Care of Michigan, P.C.

Doing business as Livonia Dental Care

  • General Practice Dentistry
  • Livonia, MI
National Provider Identifier
1447836242
Registry record updated Mar 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
LIFETIME DENTAL CARE OF MICHIGAN, P.C.
Doing business as
Livonia Dental Care
Practice address
33428 5 Mile Rd
Livonia, MI 48154-2860
Phone
(734) 427-7555
NPI assigned
Mar 22, 2021
Last updated
Mar 22, 2021By the provider in NPPES
Organization subpart
Yes
Parent organization
LIFETIME DENTAL CARE OF MICHIGAN, P.C.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 22, 2021

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

Authorized official

Name
Tabatha Lemke
Title
Credentialing Coordinator
Phone
(217) 540-6078

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X NU Primary

Addresses

Primary practice location

33428 5 Mile Rd
Livonia, MI 48154-2860

Mailing address

33428 5 Mile Rd
Livonia, MI 48154-2860
Phone (734) 427-7555

Other names 1

  • Livonia Dental Care Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Lifetime Dental Care of Michigan PC24 organizations share this tax ID, including this one
Part of
Lifetime Dental Care of Michigan PC

Other organizations with this tax ID 23

Organizations that report the same tax identification number in the National Provider Directory.

View all 23

Locations

33428 5 Mile Rd
Livonia, MI 48154
Phone (734) 427-7555

Practitioners & affiliated clinicians

Practitioners 10

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1616371200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1616371200000",
    "number": "1447836242",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "33428 5 MILE RD",
            "city": "LIVONIA",
            "state": "MI",
            "postal_code": "481542860",
            "telephone_number": "734-427-7555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "33428 5 MILE RD",
            "city": "LIVONIA",
            "state": "MI",
            "postal_code": "481542860",
            "telephone_number": "734-427-7555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFETIME DENTAL CARE OF MICHIGAN, P.C.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "LIFETIME DENTAL CARE OF MICHIGAN, P.C.",
        "enumeration_date": "2021-03-22",
        "last_updated": "2021-03-22",
        "certification_date": "2021-03-22",
        "status": "A",
        "authorized_official_last_name": "LEMKE",
        "authorized_official_first_name": "TABATHA",
        "authorized_official_title_or_position": "CREDENTIALING COORDINATOR",
        "authorized_official_telephone_number": "217-540-6078"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Livonia Dental Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Livonia, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2021; 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.