Individual provider Active NPI

Luz Lim Bargren, DDS

  • Dentist
  • Stevensville, MI
National Provider Identifier
1720243249
Registry record updated Feb 7, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
2901019905 Issued in MI
Practice address
5638 Cleveland Ave
Stevensville, MI 49127-9696
Phone
(269) 429-4661
Fax
(269) 429-4486
NPI assigned
Jul 24, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 7, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 2901019905 MI Primary

Addresses

Primary practice location

5638 Cleveland Ave
Stevensville, MI 49127-9696

Mailing address

5638 Cleveland Ave
Stevensville, MI 49127-9696
Phone (269) 429-4661

Other names 1

  • Marialuz L. Tansinsin Former name

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
I20160927001039 MI Order and Referring Only - DentistPractitioner - Dentist 5597949784

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2901019905MIMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Lakshore Family Dental Dentist 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": "1216857600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1328572800000",
    "number": "1720243249",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5638 CLEVELAND AVE",
            "city": "STEVENSVILLE",
            "state": "MI",
            "postal_code": "491279696",
            "telephone_number": "269-429-4661",
            "fax_number": "269-429-4486"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5638 CLEVELAND AVE",
            "city": "STEVENSVILLE",
            "state": "MI",
            "postal_code": "491279696",
            "telephone_number": "269-429-4661",
            "fax_number": "269-429-4486"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BARGREN",
        "first_name": "LUZ",
        "middle_name": "LIM",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-07-24",
        "last_updated": "2012-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MI",
            "license": "2901019905",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARIALUZ",
            "last_name": "TANSINSIN",
            "middle_name": "L.",
            "credential": "DDS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Stevensville, MI

Sources for this page

Verify at the official NPI Registry.