Lynn Michelle Eickholt, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

2901019857 Issued in MI

Practice address

5716 Michigan Ave
Detroit, MI 48210-3039

Phone

(313) 554-3880

Fax

(313) 899-3550

NPI assigned

Jul 15, 2008

Sex

Female

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

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.

• Covenant Community Care, Inc.

  • Federally Qualified Health Center (FQHC)
  • Detroit, MI
  • NPI 1720134943
  Medicare reassignment

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

{
    "created_epoch": "1216080000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652832000000",
    "number": "1669636072",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "559 W GRAND BLVD",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482162200",
            "telephone_number": "313-554-0485",
            "fax_number": "313-228-0283"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5716 MICHIGAN AVE",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482103039",
            "telephone_number": "313-554-3880",
            "fax_number": "313-899-3550"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1700 Waterman St",
            "address_purpose": "LOCATION",
            "city": "Detroit",
            "state": "MI",
            "postal_code": "482092022",
            "country_code": "US",
            "telephone_number": "313-355-4301",
            "fax_number": "313-554-1918",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "20901 Moross Rd",
            "address_purpose": "LOCATION",
            "city": "Detroit",
            "state": "MI",
            "postal_code": "482362058",
            "country_code": "US",
            "telephone_number": "313-626-2620",
            "fax_number": "313-649-2195",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "EICKHOLT",
        "first_name": "LYNN",
        "middle_name": "MICHELLE",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-07-15",
        "last_updated": "2022-05-18",
        "certification_date": "2022-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "2901019857",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dianna Grace Ehlert, MSN, RN, AGACNP-BC
• Murray Norman Ehrinpreis, MD
• Robert Russell Ehrman, M.D.
• Michael S. Eichenhorn, M.D.
• Ekaterina Mariah Eichler, NONE
• Fatima Eid
• Hanna Abdallah Eid, R.PH.
• Joe Eid, MD
• Rene Abdallah Eid, R.PH.
• Jacob George Eide, M.D.

• General Practice Dentistry in Detroit, MI
• Providers in Detroit, 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 May 18, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.