Active NPI
Vincent P Lizzio, DDS
- Dentist
- Allen Park, MI
National Provider Identifier
1972662237
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 15442
- Practice address
- 6760 Allen Rd
Ste 101
Allen Park, MI 48101 - Phone
- (313) 928-9464
- Fax
- (313) 928-9102
- NPI assigned
- Dec 6, 2006
- Last updated
- Jul 8, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 15442 | MI | Primary |
Addresses
Primary practice location
6760 Allen Rd
Ste 101
Allen Park, MI 48101
Mailing address
47875 Adriana CT
Canton, MI 48187
Phone (734) 453-3927
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MI
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160323000924 | MI | Order and Referring Only - Oral Surgery | 8921305681 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 15442 | MI | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1165363200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1972662237",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "47875 ADRIANA CT",
"city": "CANTON",
"state": "MI",
"postal_code": "48187",
"telephone_number": "734-453-3927"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6760 ALLEN RD",
"address_2": "STE 101",
"city": "ALLEN PARK",
"state": "MI",
"postal_code": "48101",
"telephone_number": "313-928-9464",
"fax_number": "313-928-9102"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LIZZIO",
"first_name": "VINCENT",
"middle_name": "P",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-12-06",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "MI",
"license": "15442",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Allen Park, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.