Individual provider Active NPI

Michelle B. Lancour, DDS

  • Dentist
  • Dublin, OH
National Provider Identifier
1922193168
Registry record updated Aug 22, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
30019558 Issued in OH
Practice address
5880 Saw Mill Rd
Suite 100
Dublin, OH 43017
Phone
(614) 764-0606
Fax
(614) 764-0640
NPI assigned
Oct 4, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 22, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 30019558 OH Primary

Addresses

Primary practice location

5880 Saw Mill Rd
Suite 100
Dublin, OH 43017

Mailing address

5880 Saw Mill Rd
Suite 100
Dublin, OH 43017
Phone (614) 764-0606

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160621002550 OH Order and Referring Only - DentistPractitioner - Dentist 9931490075

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
30019558OHMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1159920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1377129600000",
    "number": "1922193168",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5880 SAW MILL RD",
            "address_2": "SUITE 100",
            "city": "DUBLIN",
            "state": "OH",
            "postal_code": "43017",
            "telephone_number": "614-764-0606",
            "fax_number": "614-764-0640"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5880 SAW MILL RD",
            "address_2": "SUITE 100",
            "city": "DUBLIN",
            "state": "OH",
            "postal_code": "43017",
            "telephone_number": "614-764-0606",
            "fax_number": "614-764-0640"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANCOUR",
        "first_name": "MICHELLE",
        "middle_name": "B.",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-04",
        "last_updated": "2013-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "OH",
            "license": "30019558",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dublin, OH

Sources for this page

Verify at the official NPI Registry.