Mark J Lodge

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

MARK J LODGE

Practice address

134 High St
Grand Blanc, MI 48439-1335

Phone

(810) 694-8073

Fax

(810) 694-1764

NPI assigned

Aug 22, 2023

Last updated

Aug 22, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Sandra Smith

Title

Office Manager

Phone

(810) 694-8073

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Mark J Lodge, DDS

  • General Practice Dentistry
  • Grand Blanc, MI
  • NPI 1609906791
  NPD (past)

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

{
    "created_epoch": "1692662400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1692662400000",
    "number": "1790569622",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "134 HIGH ST",
            "city": "GRAND BLANC",
            "state": "MI",
            "postal_code": "484391335",
            "telephone_number": "810-694-8073",
            "fax_number": "810-694-1764"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "134 HIGH ST",
            "city": "GRAND BLANC",
            "state": "MI",
            "postal_code": "484391335",
            "telephone_number": "810-694-8073",
            "fax_number": "810-694-1764"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARK J LODGE",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-08-22",
        "last_updated": "2023-08-22",
        "certification_date": "2023-08-22",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "SANDRA",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "810-694-8073",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Paul J Marcinkoski, DPT
• Monir Radwan Mardini, MD
• Divine Joi Mares
• Dennis Michael Marien, PA
• Marjorie a Soper P.C.
• Andrea Markell, LMSW
• Daniel L Markley, OD
• Lauren Marko, PA
• Matthew J. Marquart, DO
• Deborah L Marsac, RPH

• General Practice Dentistry in Grand Blanc, MI
• Providers in Grand Blanc, MI by specialty
• General Practice Dentistry in Michigan

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