John Anthony Lark, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

2901015006 Issued in MI

Practice address

1136 Country Club Rd
Suite B
Adrian, MI 49221

Phone

(517) 263-9022

Fax

(517) 263-9155

NPI assigned

Nov 22, 2006

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

Practice roles

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

• Family Medical Center of Michigan,Inc

  • Federally Qualified Health Center (FQHC)
  • Temperance, MI
  • NPI 1265591812

  Corporate Director

  CMS ownership

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.

• John a Lark DDS PC

  • Dentist
  • Adrian, MI
  • NPI 1114380094
  NPD (past)
• Lifetime Dental Care of Michigan, P.C.

  • General Practice Dentistry
  • Adrian, MI
  • NPI 1922500917
  NPD (past)

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

{
    "created_epoch": "1164153600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1487729471",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1136 COUNTRY CLUB RD",
            "address_2": "SUITE B",
            "city": "ADRIAN",
            "state": "MI",
            "postal_code": "49221",
            "telephone_number": "517-263-9022",
            "fax_number": "517-263-9155"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1136 COUNTRY CLUB RD",
            "address_2": "SUITE B",
            "city": "ADRIAN",
            "state": "MI",
            "postal_code": "49221",
            "telephone_number": "517-263-9022",
            "fax_number": "517-263-9155"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LARK",
        "first_name": "JOHN",
        "middle_name": "ANTHONY",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-22",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MI",
            "license": "2901015006",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Therese M Langan, LMSW
• Kara Lange, LLPC
• Mary Catherine Lange, LMSW
• Sophia Erin Lanzi
• Claudia Lark, LLPC
• Rosemary Elizabeth Larson Mendizabal, LMT
• Melissa Kay Larson, RN
• Lawrence Desjarlais MD PC
• Brenda Lawson, CPSS
• Tricia Marie Lay

• Dentist in Adrian, MI
• Providers in Adrian, MI by specialty
• Dentist in Michigan

• 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.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.