Sofia Bock Bracamonte, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

2901602595 Issued in MI

Practice address

818 W Lake Lansing Rd
East Lansing, MI 48823-1308

Phone

(517) 333-9500

NPI assigned

Jun 27, 2025

Sex

Female

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Elan Lake Lansing

  • Dental Clinic/Center
  • East Lansing, MI
  • NPI 1811482565
  NPD (past)
• Gary H. Dwight, D.D.S., P.C.

  • Clinic/Center
  • East Lansing, MI
  • NPI 1023296571
  NPD (past)

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

{
    "created_epoch": "1750982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750982400000",
    "number": "1497644223",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2781 SYCAMORE RIVER DR",
            "city": "FOWLERVILLE",
            "state": "MI",
            "postal_code": "488368621",
            "telephone_number": "407-686-2047"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "818 W LAKE LANSING RD",
            "city": "EAST LANSING",
            "state": "MI",
            "postal_code": "488231308",
            "telephone_number": "517-333-9500"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2445 Woodlake Cir",
            "address_purpose": "LOCATION",
            "city": "Okemos",
            "state": "MI",
            "postal_code": "488645941",
            "country_code": "US",
            "telephone_number": "517-246-3838",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOCK BRACAMONTE",
        "first_name": "SOFIA",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-06-27",
        "last_updated": "2025-06-27",
        "certification_date": "2025-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "2901602595",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Board of Trustees of Michigan State University
• Mindy Beth Boase, CTRS, CBIS
• Sean Boatman
• Breyana Bobo
• Amanda Bocanegra, CCSH
• Sharalee Boda
• Shelby Boelens
• Maribeth Bohlman
• Abigail Lyn Bokor
• Chanda Bolander, LLMSW

• General Practice Dentistry in East Lansing, MI
• Providers in East Lansing, 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 Jun 27, 2025; 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.