Four Seasons Dental Associates PLLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

FOUR SEASONS DENTAL ASSOCIATES PLLC

Practice address

301 Main St
Lake City, MI 49651-0589

Phone

(231) 839-4673

Fax

(231) 839-7874

NPI assigned

Nov 29, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Dennis E Bushon, DDS

Title

Member

Phone

(231) 839-4673

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 1

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

• Michael Francis Lahey, DDS

  • General Practice Dentistry
  • Lake City, MI
  • NPI 1659435287
  NPD (past)

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

{
    "created_epoch": "1164758400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1821165499",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 589",
            "address_2": "301 MAIN ST",
            "city": "LAKE CITY",
            "state": "MI",
            "postal_code": "496510589",
            "telephone_number": "231-839-4673",
            "fax_number": "231-839-7874"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 MAIN ST",
            "city": "LAKE CITY",
            "state": "MI",
            "postal_code": "496510589",
            "telephone_number": "231-839-4673",
            "fax_number": "231-839-7874"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOUR SEASONS DENTAL ASSOCIATES PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-29",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BUSHON",
        "authorized_official_first_name": "DENNIS",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "231-839-4673",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF MICHIGAN",
            "identifier": "8011320",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jill Marie Farley, LMSW
• Ashley Flint
• Footprints in Time
• Erica Louise Foster, R.N. W.C.C.
• Foster'S Super Markets, Inc
• Jennifer Freeman, BCBA
• Anthony Frey
• Kendra Dee Gibson, RD
• Samantha Marie Goschke, CTRS
• Patricia Anita Grier, MS, PT

• General Practice Dentistry in Lake City, MI
• Providers in Lake City, 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, 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.