Maris J Lans, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

019.030525 Issued in IL

Practice address

507 N Hershey Rd Ste D
Bloomington, IL 61704-3744

Phone

(309) 664-2288

NPI assigned

Mar 16, 2018

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Dental Professionals of Illinois, P.C.

  • General Practice Dentistry
  • Bloomington, IL
  • NPI 1285847541
  NPD (past)

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

{
    "created_epoch": "1521158400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521158400000",
    "number": "1962905802",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "507 N HERSHEY RD STE D",
            "city": "BLOOMINGTON",
            "state": "IL",
            "postal_code": "617043744"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "507 N HERSHEY RD STE D",
            "city": "BLOOMINGTON",
            "state": "IL",
            "postal_code": "617043744",
            "telephone_number": "309-664-2288"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANS",
        "first_name": "MARIS",
        "middle_name": "J",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-03-16",
        "last_updated": "2018-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": "019.030525",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christine L. Lane, LCPC
• Madilyn Ann Lane
• Mfowethu Theophilus Langeni, DO
• Marie-Susanne Langille, PTA
• Ashley Langley, APN
• Christopher D Lansford, MD
• Mark Lanzerotte, MD
• Brian M Larimore, MSW
• Kendra Larimore
• Joanne M Larow, DO

• Dentist in Bloomington, IL
• Providers in Bloomington, IL by specialty
• Dentist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2018; 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.