NPIMap

Organization Active NPI

Evergreen Dental Center,PLLC

  • Dentist
  • Lansing, MI
National Provider Identifier
1548422264
Registry record updated Jun 25, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
EVERGREEN DENTAL CENTER,PLLC
Practice address
2805 E Mount Hope Ave
Lansing, MI 48910-1916
Phone
(517) 484-5811
Fax
(517) 484-5873
NPI assigned
Jun 25, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2008

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

Authorized official

Name
Dr. Jason W Hartman, DDS
Title
Managing Partner
Phone
(517) 484-5811

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 122300000X Primary

Addresses

Primary practice location

2805 E Mount Hope Ave
Lansing, MI 48910-1916

Mailing address

2805 E Mount Hope Ave
Lansing, MI 48910-1916
Phone (517) 484-5811

National Provider Directory

National Provider Directory

Locations

2805 E Mount Hope Ave
Lansing, MI 48910
Phone (517) 484-5811

NPI Registry JSON

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

{
    "created_epoch": "1214352000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1214352000000",
    "number": "1548422264",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2805 E MOUNT HOPE AVE",
            "city": "LANSING",
            "state": "MI",
            "postal_code": "489101916",
            "telephone_number": "517-484-5811",
            "fax_number": "517-484-5873"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2805 E MOUNT HOPE AVE",
            "city": "LANSING",
            "state": "MI",
            "postal_code": "489101916",
            "telephone_number": "517-484-5811",
            "fax_number": "517-484-5873"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EVERGREEN DENTAL CENTER,PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-25",
        "last_updated": "2008-06-25",
        "status": "A",
        "authorized_official_last_name": "HARTMAN",
        "authorized_official_first_name": "JASON",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "MANAGING PARTNER",
        "authorized_official_telephone_number": "517-484-5811",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lansing, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2008; 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.