NPIMap

Organization Active NPI

Lifetime Dental Care of Michigan, P.C.

Doing business as Meadow Creek Dental Care

  • General Practice Dentistry
  • Rockford, MI
National Provider Identifier
1720862253
Registry record updated Aug 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
LIFETIME DENTAL CARE OF MICHIGAN, P.C.
Doing business as
Meadow Creek Dental Care
Practice address
2887 10 Mile Rd NE
Rockford, MI 49341-9100
Phone
(616) 433-2250
Fax
(616) 433-2252
NPI assigned
Aug 24, 2023
Organization subpart
Yes
Parent organization
LIFETIME DENTAL CARE OF MICHIGAN, P.C.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 24, 2023

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

Authorized official

Name
Belinda Huerta
Title
Credentialing Coordinator
Phone
(217) 540-2100

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X Primary

Addresses

Primary practice location

2887 10 Mile Rd NE
Rockford, MI 49341-9100

Mailing address

2887 10 Mile Rd NE
Rockford, MI 49341-9100
Phone (616) 433-2250

Other names 1

  • Meadow Creek Dental Care Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Lifetime Dental Care of Michigan PC24 organizations share this tax ID, including this one
Part of
Lifetime Dental Care of Michigan PC

Other organizations with this tax ID 23

Organizations that report the same tax identification number in the National Provider Directory.

View all 23

Locations

2887 10 Mile Rd NE
Rockford, MI 49341
Phone (616) 433-2250

Practitioners & affiliated clinicians

Practitioners 1

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": "1692835200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1692835200000",
    "number": "1720862253",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2887 10 MILE RD NE",
            "city": "ROCKFORD",
            "state": "MI",
            "postal_code": "493419100",
            "telephone_number": "616-433-2250",
            "fax_number": "616-433-2252"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2887 10 MILE RD NE",
            "city": "ROCKFORD",
            "state": "MI",
            "postal_code": "493419100",
            "telephone_number": "616-433-2250",
            "fax_number": "616-433-2252"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFETIME DENTAL CARE OF MICHIGAN, P.C.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "LIFETIME DENTAL CARE OF MICHIGAN, P.C.",
        "enumeration_date": "2023-08-24",
        "last_updated": "2023-08-24",
        "certification_date": "2023-08-23",
        "status": "A",
        "authorized_official_last_name": "HUERTA",
        "authorized_official_first_name": "BELINDA",
        "authorized_official_title_or_position": "CREDENTIALING COORDINATOR",
        "authorized_official_telephone_number": "217-540-2100"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Meadow Creek Dental Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Rockford, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2023; 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.