NPIMap

Organization Active NPI

Lifetime Dental Care of Michigan, P.C.

Doing business as Walker Dental Care

  • General Practice Dentistry
  • Walker, MI
National Provider Identifier
1811672199
Registry record updated Jun 15, 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
Walker Dental Care
Practice address
348 Wilson Ave NW
Walker, MI 49534-3555
Phone
(616) 317-2485
Fax
(616) 317-2406
NPI assigned
Jun 15, 2023
Last updated
Jun 15, 2023By the provider in NPPES
Organization subpart
Yes
Parent organization
LIFETIME DENTAL CARE OF MICHIGAN, P.C.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 15, 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 Dentistry 1223G0001X Primary

Addresses

Primary practice location

348 Wilson Ave NW
Walker, MI 49534-3555

Mailing address

348 Wilson Ave NW
Walker, MI 49534-3555
Phone (616) 317-2485

Other names 1

  • Walker 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

348 Wilson Ave NW
Walker, MI 49534
Phone (616) 317-2485

Practitioners & affiliated clinicians

Practitioners 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1686787200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1686787200000",
    "number": "1811672199",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "348 WILSON AVE NW",
            "city": "WALKER",
            "state": "MI",
            "postal_code": "495343555",
            "telephone_number": "616-317-2485",
            "fax_number": "616-317-2406"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "348 WILSON AVE NW",
            "city": "WALKER",
            "state": "MI",
            "postal_code": "495343555",
            "telephone_number": "616-317-2485",
            "fax_number": "616-317-2406"
        }
    ],
    "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": "2023-06-15",
        "last_updated": "2023-06-15",
        "certification_date": "2023-06-07",
        "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": "",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Walker Dental Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Walker, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 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.