Individual provider Active NPI

Lauren Ann Hall-Tate, D.D.S.

  • Dentist
  • Lansing, MI
National Provider Identifier
1497746119
Registry record updated Dec 28, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
2901013605 Issued in MI
Practice address
200 N Homer St
Lansing, MI 48912-4741
Phone
(517) 351-9070
Fax
(517) 351-6036
NPI assigned
Nov 2, 2005
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 28, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 2901013605 MI Primary

Addresses

Primary practice location

200 N Homer St
Lansing, MI 48912-4741

Mailing address

200 N Homer St
Lansing, MI 48912-4741
Phone (517) 351-9070

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160602001874 MI Order and Referring Only - DentistPractitioner - Dentist 5991095952

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2901013605MIMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1130889600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1356652800000",
    "number": "1497746119",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 N HOMER ST",
            "city": "LANSING",
            "state": "MI",
            "postal_code": "489124741",
            "telephone_number": "517-351-9070",
            "fax_number": "517-351-6036"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 N HOMER ST",
            "city": "LANSING",
            "state": "MI",
            "postal_code": "489124741",
            "telephone_number": "517-351-9070",
            "fax_number": "517-351-6036"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALL-TATE",
        "first_name": "LAUREN",
        "middle_name": "ANN",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-11-02",
        "last_updated": "2012-12-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MI",
            "license": "2901013605",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lansing, MI

Sources for this page

Verify at the official NPI Registry.