Individual provider Active NPI

Lauren Trancik, DDS

  • General Practice Dentistry
  • Jackson, MI
National Provider Identifier
1770955114
Registry record updated Oct 26, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
2901021756 Issued in MI
Practice address
1030 Laurence Ave
Jackson, MI 49202-2983
Phone
(517) 782-1467
NPI assigned
Oct 26, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 26, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 2901021756 MI Primary
General Practice Dentistry 1223G0001X 12012398A IN

Addresses

Primary practice location

1030 Laurence Ave
Jackson, MI 49202-2983

Mailing address

1030 Laurence Ave
Jackson, MI 49202-2983
Phone (517) 782-1467

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20161228000642 TX Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 2062793342

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
12012398AINMDGeneral Practice Dentistry
2901021756MIMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1445817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1445817600000",
    "number": "1770955114",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1030 LAURENCE AVE",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492022983",
            "telephone_number": "517-782-1467"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1030 LAURENCE AVE",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492022983",
            "telephone_number": "517-782-1467"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRANCIK",
        "first_name": "LAUREN",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-10-26",
        "last_updated": "2015-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "2901021756",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IN",
            "license": "12012398A",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, MI

Sources for this page

Verify at the official NPI Registry.