David Lester Latz, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

11083 Issued in MI

Practice address

2633 Shirley Dr
Jackson, MI 49201

Phone

(517) 787-2516

Fax

(517) 787-7734

NPI assigned

Jul 25, 2006

Last updated

Apr 20, 2012By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Jan 19, 2016 through Jan 19, 2028

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Sara Kellogg DDS PC

  • Dentist
  • Jackson, MI
  • NPI 1669916227
  NPD (past)

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

{
    "created_epoch": "1153785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1334880000000",
    "number": "1679596472",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2633 SHIRLEY DR",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "49284",
            "telephone_number": "517-787-2516",
            "fax_number": "517-787-7734"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2633 SHIRLEY DR",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "49201",
            "telephone_number": "517-787-2516",
            "fax_number": "517-787-7734"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LATZ",
        "first_name": "DAVID",
        "middle_name": "LESTER",
        "name_prefix": "Mr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-25",
        "last_updated": "2012-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MI",
            "license": "11083",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "11083",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kortani Larson
• Michele Laskey
• Lindsey Shae Lassila
• Katherine Ann Latendresse, DDS
• Cynthia Sue Latka, LLPC
• Breanna Maria Lauinger
• Laura Putney LMSW LLC
• Raechelle Marie Laura, RN
• Koral Lavasseur
• Kathleen A Lavery, CNM

• Dentist in Jackson, MI
• Providers in Jackson, MI by specialty
• Dentist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2012; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.