Lighthouse Dental 63090

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

LIGHTHOUSE DENTAL 63090

Practice address

560 E 14TH St
Washington, MO 63090-4535

Phone

(636) 390-9991

NPI assigned

Aug 3, 2022

Organization subpart

No

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

Authorized official

Name

Dr. Melissa K Zyk, DDSNPI 1770564858

Title

Owner

Phone

(636) 390-9991

Specialties & licenses 1

Addresses

Other identifiers 2

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Melissa K Zyk, D.D.S.

  • General Practice Dentistry
  • Washington, MO
  • NPI 1770564858
  NPD Authorized official

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

{
    "created_epoch": "1659484800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1659484800000",
    "number": "1801523592",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "560 E 14TH ST",
            "city": "WASHINGTON",
            "state": "MO",
            "postal_code": "630904535",
            "telephone_number": "636-390-9991"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "560 E 14TH ST",
            "city": "WASHINGTON",
            "state": "MO",
            "postal_code": "630904535",
            "telephone_number": "636-390-9991"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIGHTHOUSE DENTAL 63090",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-08-03",
        "last_updated": "2022-08-03",
        "certification_date": "2022-08-03",
        "status": "A",
        "authorized_official_last_name": "ZYK",
        "authorized_official_first_name": "MELISSA",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "636-390-9991",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BRITTANY BOCKHORST",
            "identifier": "1578977104",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MELISSA ZYK",
            "identifier": "1770564858",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ann Libs, WHNP
• Rocky Christopher Liesman, PSY.D
• Melissa Elizabeth Liesmann, PHARM.D.
• Life Balance Counseling LLC
• Life of Wellness Counseling LLC
• Jonathan N Limpert, M. D.
• Lincare Inc.
• Josie Rae Lindemann
• Yona Renee Lindenbaum, OT
• Christian David Linz, D.O.

• General Practice Dentistry in Washington, MO
• Providers in Washington, MO by specialty
• General Practice Dentistry in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2022; 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.