Seven Lakes Periodontics

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

18270 Issued in MI

Legal business name

SEVEN LAKES PERIODONTICS

Practice address

1100 Torrey Rd
Suite 500
Fenton, MI 48430-3327

Phone

(810) 750-3400

NPI assigned

Jan 5, 2006

Organization subpart

No

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

Authorized official

Name

Diego Velasquez-Plata, DDS, MSDNPI 1336127786

Title

President

Phone

(810) 750-3400

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.

• Diego Velasquez-Plata, DDS, MSD

  • Periodontics
  • Fenton, MI
  • NPI 1336127786
  NPD (past) Authorized official

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

{
    "created_epoch": "1136419200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1922086370",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 TORREY RD",
            "address_2": "SUITE 500",
            "city": "FENTON",
            "state": "MI",
            "postal_code": "484303327",
            "telephone_number": "810-750-3400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 TORREY RD",
            "address_2": "SUITE 500",
            "city": "FENTON",
            "state": "MI",
            "postal_code": "484303327",
            "telephone_number": "810-750-3400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SEVEN LAKES PERIODONTICS",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-05",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "VELASQUEZ-PLATA",
        "authorized_official_first_name": "DIEGO",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "810-750-3400",
        "authorized_official_credential": "DDS, MSD"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Periodontics",
            "state": "MI",
            "license": "18270",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Justine Seeley
• Larry Joe Segroves, D.O.
• Eric Scott Seiger, DO
• Sequoia Psychological Services
• Serenity Recovery Services LLC
• Michelle Ann Sgalia, D.D.S.
• My Le Shaw, M.D.
• Susan Marie Shaw, LPC
• Darcy Shay, FNP
• Madison Shegos, PA-C

• Periodontics in Fenton, MI
• Providers in Fenton, MI by specialty
• Periodontics 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.