Henry D Lyon, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

2901012527 Issued in MI

Practice address

2454 W Glenlord Rd
Stevensville, MI 49127-9557

Phone

(269) 428-2222

Fax

(269) 428-4444

NPI assigned

Jul 26, 2006

Last updated

Sep 26, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Intercare Community Health Network

  • Federally Qualified Health Center (FQHC)
  • Bangor, MI
  • NPI 1326058512
  Medicare reassignment NPD
• Henry D Lyon DDS PC

  dba Emergency Dental

  • Dental Clinic/Center
  • Stevensville, MI
  • NPI 1881166429
  NPD (past) Authorized official
• Intercare Community Health Network

  dba InterCare Child and Adolescent Behavioral Health Center

  • Federally Qualified Health Center (FQHC)
  • Eau Claire, MI
  • NPI 1336701119
  NPD

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

{
    "created_epoch": "1153872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1190764800000",
    "number": "1467476184",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2454 W GLENLORD RD",
            "city": "STEVENSVILLE",
            "state": "MI",
            "postal_code": "491279557",
            "telephone_number": "269-428-2222",
            "fax_number": "269-428-4444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2454 W GLENLORD RD",
            "city": "STEVENSVILLE",
            "state": "MI",
            "postal_code": "491279557",
            "telephone_number": "269-428-2222",
            "fax_number": "269-428-4444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LYON",
        "first_name": "HENRY",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-26",
        "last_updated": "2007-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "2901012527",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sarah Leese, PA-C
• Life Steps Family Counseling
• Life Vision Eyecare, PLLC (Life Vision Eyecare)
• Kyesha Ariane Lipscomb, PHARM. D.
• Anna Lonto, DPT
• Jeremy Michael Malzon, MA, LPC
• Heather A Marten, MD
• Martin's Super Markets of Stevensville LLC (Martin's Pharmacy #23 Stevensville)
• Kayla Nicole Martinez, LMT
• Nancy Mason, LCSW

• General Practice Dentistry in Stevensville, MI
• Providers in Stevensville, 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 Sep 26, 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.