Lakehsore Otolaryngology

Primary specialty

Facial Plastic Surgery PhysicianTaxonomy code 207YS0123X

Legal business name

LAKEHSORE OTOLARYNGOLOGY

Practice address

577 Michigan Avenue
Suite 101
Holland, MI 49423

Phone

(616) 393-2190

Fax

(616) 393-0147

NPI assigned

Aug 16, 2006

Organization subpart

No

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

Authorized official

Name

Theodore S Vanderveen, M.D.

Title

President

Phone

(616) 393-2190

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1155686400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1770696379",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "577 MICHIGAN AVENUE",
            "address_2": "SUITE 101",
            "city": "HOLLAND",
            "state": "MI",
            "postal_code": "49423",
            "telephone_number": "616-393-2190",
            "fax_number": "616-393-0147"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "577 MICHIGAN AVENUE",
            "address_2": "SUITE 101",
            "city": "HOLLAND",
            "state": "MI",
            "postal_code": "49423",
            "telephone_number": "616-393-2190",
            "fax_number": "616-393-0147"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKEHSORE OTOLARYNGOLOGY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-16",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "VANDERVEEN",
        "authorized_official_first_name": "THEODORE",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "616-393-2190",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207YS0123X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Otolaryngology, Facial Plastic Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elizabeth Annmarie Lahrman, BCBA; M.ED.
• Janet Laing, LMSW, CAADC, CCS-M
• Lake Michigan Anesthesia Staffing LLC
• Lake Michigan Dermatology PLLC
• Lake Michigan Wellness PLLC
• Lakeshore Allergy PC
• Lakeshore Area Radiation Oncology Center
• Lakeshore Eyecare Center PC
• Lakeshore Family Chiropractic, PLC
• Lakeshore Health Partners

• Facial Plastic Surgery Physician in Holland, MI
• Providers in Holland, MI by specialty
• Facial Plastic Surgery Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.