NPIMap

Organization Active NPI

Lifetime Dental Care of Michigan, P.C.

  • General Practice Dentistry
  • Battle Creek, MI
National Provider Identifier
1821743089
Registry record updated Feb 16, 2022
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.
Practice address
3620 Capital Ave SW Ste a
Battle Creek, MI 49015-9348
Phone
(269) 979-1500
NPI assigned
Feb 16, 2022
Organization subpart
Yes
Parent organization
LIFETIME DENTAL CARE OF MICHIGAN, P.C.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 16, 2022

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

Authorized official

Name
Hillary Thull
Title
Credentialing Coordinator
Phone
(217) 540-8946

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X Primary

Addresses

Primary practice location

3620 Capital Ave SW Ste a
Battle Creek, MI 49015-9348

Mailing address

3620 Capital Ave SW Ste a
Battle Creek, MI 49015-9348

Other names 1

  • Capital Avenue 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

3620 Capital Ave SW
Ste A
Battle Creek, MI 49015
Phone (269) 979-1500

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1644969600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1644969600000",
    "number": "1821743089",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3620 CAPITAL AVE SW STE A",
            "city": "BATTLE CREEK",
            "state": "MI",
            "postal_code": "490159348"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3620 CAPITAL AVE SW STE A",
            "city": "BATTLE CREEK",
            "state": "MI",
            "postal_code": "490159348",
            "telephone_number": "269-979-1500"
        }
    ],
    "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": "2022-02-16",
        "last_updated": "2022-02-16",
        "certification_date": "2022-02-16",
        "status": "A",
        "authorized_official_last_name": "THULL",
        "authorized_official_first_name": "HILLARY",
        "authorized_official_title_or_position": "CREDENTIALING COORDINATOR",
        "authorized_official_telephone_number": "217-540-8946"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Capital Avenue Dental Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Battle Creek, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 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.