Individual provider Active NPI

Christa Letizia Stern-Lubahn, DDS

  • General Practice Dentistry
  • Big Rapids, MI
National Provider Identifier
1619978087
Registry record updated Nov 16, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
17912 Issued in MI
Practice address
106 Locust St
Big Rapids, MI 49307-2006
Phone
(231) 796-8770
Fax
(231) 796-4427
NPI assigned
Aug 9, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 16, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 17912 MI Primary

Addresses

Primary practice location

106 Locust St
Big Rapids, MI 49307-2006

Mailing address

106 Locust St
Big Rapids, MI 49307-2006
Phone (231) 796-8770

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
I20151118000032 MI Order and Referring Only - DentistPractitioner - Dentist 4082914379

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
17912MIMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Caring Family Dentistry PC General Practice Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1123545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1447632000000",
    "number": "1619978087",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "106 LOCUST ST",
            "city": "BIG RAPIDS",
            "state": "MI",
            "postal_code": "493072006",
            "telephone_number": "231-796-8770",
            "fax_number": "231-796-4427"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "106 LOCUST ST",
            "city": "BIG RAPIDS",
            "state": "MI",
            "postal_code": "493072006",
            "telephone_number": "231-796-8770",
            "fax_number": "231-796-4427"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STERN-LUBAHN",
        "first_name": "CHRISTA",
        "middle_name": "LETIZIA",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-09",
        "last_updated": "2015-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "17912",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Big Rapids, MI

Sources for this page

Verify at the official NPI Registry.