Main Street Dental PLLC

Primary specialty

DentistTaxonomy code 122300000X

Legal business name

MAIN STREET DENTAL PLLC

Practice address

123 S Main St
Olivet, MI 49076-9404

Phone

(269) 749-9477

Fax

(269) 749-9810

NPI assigned

Apr 8, 2022

Organization subpart

No

Name

Lana Lewis, DDSNPI 1619072691

Title

Member

Phone

(269) 749-9477

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Lana J Lewis, D.D.S.

  • General Practice Dentistry
  • Olivet, MI
  • NPI 1619072691
  NPD Authorized official

Locations

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Apr 8, 2022.

{
    "created_epoch": "1649376000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1649376000000",
    "number": "1679215818",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 536",
            "city": "OLIVET",
            "state": "MI",
            "postal_code": "490760536",
            "telephone_number": "269-749-9477"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "123 S MAIN ST",
            "city": "OLIVET",
            "state": "MI",
            "postal_code": "490769404",
            "telephone_number": "269-749-9477",
            "fax_number": "269-749-9810"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAIN STREET DENTAL PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-04-08",
        "last_updated": "2022-04-08",
        "certification_date": "2022-04-08",
        "status": "A",
        "authorized_official_last_name": "LEWIS",
        "authorized_official_first_name": "LANA",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "269-749-9477",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Health Simplified L.L.C.
• Angela Dawn Heisler, PTA
• Tanisha Kingsbury
• Lagarde Psychological Group
• Lana J Lewis, D.D.S.
• Deanna L Mistretta, L.P.N.
• Wendy Jo Murray
• Next Step Home Health and Staffing, LLC
• Olivet College
• Olivet Pharmacy Inc

• All providers in Olivet, MI
• Dentist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2022; 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.