Active NPI
Lauren Marie De Oliveira, DDS
- Dentist
- Plymouth, MI
National Provider Identifier
1467834606
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 2901021539
- Practice address
- 45600 Joy Rd
Plymouth, MI 48170-3660 - Phone
- (734) 459-5370
- NPI assigned
- Jun 24, 2015
- Sex
- Female
- 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 | 2901021539 | MI | Primary |
Addresses
Primary practice location
45600 Joy Rd
Plymouth, MI 48170-3660
Mailing address
15111 Drysdale St
Southgate, MI 48195-2945
Phone (734) 341-2041
Medicare participation
Medicare enrollment files- 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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160413000258 | MI | Order and Referring Only - Dentist | 1456659127 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1435104000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1720656000000",
"number": "1467834606",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "15111 DRYSDALE ST",
"city": "SOUTHGATE",
"state": "MI",
"postal_code": "481952945",
"telephone_number": "734-341-2041"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "45600 JOY RD",
"city": "PLYMOUTH",
"state": "MI",
"postal_code": "481703660",
"telephone_number": "734-459-5370"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DE OLIVEIRA",
"first_name": "LAUREN",
"middle_name": "MARIE",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-06-24",
"last_updated": "2024-07-11",
"certification_date": "2024-07-11",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "MI",
"license": "2901021539",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Plymouth, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2024; 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.