Lakeshore Plastic and Reconstructive Surgery Associates, P.C.

Primary specialty

Plastic Surgery PhysicianTaxonomy code 208200000X

Legal business name

LAKESHORE PLASTIC AND RECONSTRUCTIVE SURGERY ASSOCIATES, P.C.

Doing business as

Plastic Surgery Arts of West Michigan

Practice address

3124 N Wellness Drive
Suite 10
Holland, MI 49424-8121

Phone

(616) 738-5870

Fax

(616) 738-5872

NPI assigned

Oct 16, 2007

Last updated

Jul 21, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Ryan E Dodde II, MDNPI 1881669299

Title

President

Phone

(616) 738-5870

Specialties & licenses 1

Addresses

Other names 1

• Plastic Surgery Arts of West Michigan Doing business as

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 2

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.

• Ryan E Dodde II, M.D.

  • Plastic Surgery Physician
  • Holland, MI
  • NPI 1881669299
  Medicare reassignment NPD Authorized official
• Shannon Gerow, NP

  • Nurse Practitioner
  • Holland, MI
  • NPI 1407489586
  NPD

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

{
    "created_epoch": "1192492800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1467641373",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3124 N WELLNESS DRIVE",
            "address_2": "SUITE 10",
            "city": "HOLLAND",
            "state": "MI",
            "postal_code": "494248121",
            "telephone_number": "616-738-5870",
            "fax_number": "616-738-5872"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3124 N WELLNESS DRIVE",
            "address_2": "SUITE 10",
            "city": "HOLLAND",
            "state": "MI",
            "postal_code": "494248121",
            "telephone_number": "616-738-5870",
            "fax_number": "616-738-5872"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKESHORE PLASTIC AND RECONSTRUCTIVE SURGERY ASSOCIATES, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-16",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "DODDE",
        "authorized_official_first_name": "RYAN",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "616-738-5870",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "II",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "MI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Plastic Surgery Arts of West Michigan",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Lakeshore Area Radiation Oncology Center
• Lakeshore Eyecare Center PC
• Lakeshore Family Chiropractic, PLC
• Lakeshore Health Partners
• Lakeshore Internal Medicine and Pediatric Associates
• Lakeshore Psychological & Counseling Services, PC
• Lakeshore Senior Care LLC (Lakeshore Senior Care)
• Lakeshore Sleep Solutions, PLLC
• Lakeshore Surgical Associates PC
• Lakeside ENT, P.C.

• Plastic Surgery Physician in Holland, MI
• Providers in Holland, MI by specialty
• Plastic Surgery Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.