NPIMap

Organization Active NPI

Laketown Family Dental, PLLC

  • Dental Clinic/Center
  • Norton Shores, MI
National Provider Identifier
1689254757
Registry record updated Mar 4, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
Legal business name
LAKETOWN FAMILY DENTAL, PLLC
Practice address
340 Seminole Rd
Norton Shores, MI 49444-3733
Phone
(231) 737-2273
NPI assigned
Apr 12, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2022

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

Authorized official

Name
Dr. Eric Lendburgh Heisser, DDSNPI 1285015537
Title
Member
Phone
(231) 670-2851

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X Primary

Addresses

Primary practice location

340 Seminole Rd
Norton Shores, MI 49444-3733

Mailing address

340 Seminole Rd
Norton Shores, MI 49444-3733
Phone (231) 737-2273

Other names 2

  • Laketown Family Dental Doing business as
  • Smile Suites Dental, PLLC Former legal business name

National Provider Directory

National Provider Directory

Locations

340 Seminole Rd
Norton Shores, MI 49444
Phone (231) 670-2851

Practitioners & affiliated clinicians

Practitioners 4

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

NPI Registry JSON

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

{
    "created_epoch": "1618185600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1646352000000",
    "number": "1689254757",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "340 SEMINOLE RD",
            "city": "NORTON SHORES",
            "state": "MI",
            "postal_code": "494443733",
            "telephone_number": "231-737-2273"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "340 SEMINOLE RD",
            "city": "NORTON SHORES",
            "state": "MI",
            "postal_code": "494443733",
            "telephone_number": "231-737-2273"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKETOWN FAMILY DENTAL, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-04-12",
        "last_updated": "2022-03-04",
        "certification_date": "2022-03-04",
        "status": "A",
        "authorized_official_last_name": "HEISSER",
        "authorized_official_first_name": "ERIC",
        "authorized_official_middle_name": "LENDBURGH",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "231-670-2851",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Laketown Family Dental",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Smile Suites Dental, PLLC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Norton Shores, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 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.