DR. JOHN W. WILLOUGHBY (NPI# 1316067002) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1316067002 |
| Entity Type | Individual |
| Full Name | DR. JOHN W. WILLOUGHBY |
| Credential | DDS |
| Practice Address |
2501 Coolidge Rd Suite 201 East Lansing MI 48823-6352 |
| Practice Telephone | 5173510800 |
| Practice Fax Number | 5173513399 |
| Mailing Telephone | 5173510800 |
| Mailing Fax Number | 5173513399 |
| Enumeration Date | 2007-03-29 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223E0200X |
Dentist Specialization: Endodontics |
2901010047 | MI | Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | LICENSE # | 2901010047 | 01 |
| MI | BCBS MEDICAL PIN # | 1953360060 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245487453 | John R Willoughby | Dentist | 4326 George Washington Highway, Yorktown, VA 23692-2707 | 2008-08-20 |
| 1962847533 | John Patrick Willoughby | Internal Medicine | 50505 Schoenherr Rd Ste 290, Shelby Twp, MI 48315-3141 | 2013-05-08 |
| 1073602330 | John A. Willoughby | Psychiatry & Neurology | 900 N Orange St, Suite 202, Missoula, MT 59802-2998 | 2006-10-12 |
| Street Address |
2501 COOLIDGE RD SUITE 201 |
| City | EAST LANSING |
| State | MI |
| Zip Code | 48823-6352 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013008093 | Endodontic Specialists, P.C. | Dentist | 2501 Coolidge Rd, Suite 201, East Lansing, MI 48823-6352 | 2006-09-27 |
| 1023138724 | Robert A Hershey | Dentist | 2501 Coolidge Rd, Suite 201, East Lansing, MI 48823-6352 | 2007-03-29 |
| 1033239744 | Martin J Tuck | Dentist | 2501 Coolidge Rd, Suite 201, East Lansing, MI 48823-6352 | 2007-03-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144848631 | Joseph Santangelo | Technician | 2775 E Lansing Dr, East Lansing, MI 48823 | 2020-07-10 |
| 1679197701 | Alexandra Megan Bauer | Technician | 3839 Hunsaker Street, 121, East Lansing, MI 48823 | 2020-06-04 |
| 1689297756 | Nathan Barnhurst | Neuromusculoskeletal Medicine & OMM | 4660 Hagadorn Rd #500, East Lansing, MI 48823 | 2020-05-25 |
| 1861036006 | Rachel Amber Kelly | Registered Nurse | 221 W Lake Rd, #300, East Lansing, MI 48823 | 2019-10-31 |
| 1982176442 | Thomas Patrick Lilley | Occupational Therapist | 2900 Hannah Blvd. - Suite B102, East Lansing, MI 48823 | 2018-12-21 |
| 1386114684 | Anne Colleen Jack | Social Worker | 3100 West Road, East Lansing, MI 48823 | 2018-11-29 |
| 1346721420 | Mary Ann Malosh | Health Educator | 6265 Fenwick Ct, East Lansing, MI 48823 | 2018-08-27 |
| 1639668734 | Jennifer Lynn Box | Occupational Therapist | 2900 Hannah Blvd Ste. B102, Outpatient Rehab, East Lansing, MI 48823 | 2018-05-03 |
| 1598267288 | Wise Willow Counseling & Consulting LLC | Social Worker | 2875 Northwind Dr Ste 215, East Lansing, MI 48823 | 2018-03-08 |
| 1184142010 | Carlrianna Taylor | Technician | 2775 E Lansing Rd, E Lansing, MI 48823 | 2017-08-30 |
| Find all providers in zip 48823 | ||||
| Taxonomy Code | 1223E0200X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Endodontics |
| The branch of dentistry that is concerned with the morphology, physiology and pathology of the human dental pulp and periradicular tissues. Its study and practice encompass the basic and clinical sciences including biology of the normal pulp, the etiology, diagnosis, prevention and treatment of diseases and injuries of the pulp and associated periradicular conditions. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013008093 | Endodontic Specialists, P.C. | Dentist | 2501 Coolidge Rd, Suite 201, East Lansing, MI 48823-6352 | 2006-09-27 |
| 1023138724 | Robert A Hershey | Dentist | 2501 Coolidge Rd, Suite 201, East Lansing, MI 48823-6352 | 2007-03-29 |
| 1033239744 | Martin J Tuck | Dentist | 2501 Coolidge Rd, Suite 201, East Lansing, MI 48823-6352 | 2007-03-29 |
| 1508938713 | Kevin Timothy Mullin | Dentist | 2111 Merritt Rd, Suite 102, East Lansing, MI 48823-6916 | 2006-11-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225647514 | Drs Mesh, P.C. | Dentist | 15555 Silver Parkway, Fenton, MI 48430 | 2020-07-23 |
| 1285252874 | Plymouth Endodontics | Dentist | 9416 S Main St Ste 212, Plymouth, MI 48170-4148 | 2020-07-09 |
| 1578192712 | Rabban-acho Dental Pllc | Dentist | 38550 Garfield Rd Ste C, Clinton Township, MI 48038-3406 | 2020-04-08 |
| 1700411378 | Macomb Endodontics | Dentist | 51817 Gratiot Ave, Chesterfield, MI 48051-2014 | 2020-03-04 |
| 1861950701 | Garfield Road Dental- 2 | Dentist | 15401 Dix Toledo Rd, Southgate, MI 48195-2662 | 2019-03-11 |
| 1336654102 | Elite Endodontics | Dentist | 1135 S Lapeer Rd Ste A, Lake Orion, MI 48360-1432 | 2017-12-02 |
| 1255719456 | Norton Shores Dental PC | Dentist | 837 Seminole Rd Ste 100, Norton Shores, MI 49441-6734 | 2015-05-08 |
| 1396186292 | Ryan Brooks Mcmahan | Dentist | 400 W Main St Ste 106, Gaylord, MI 49735-1870 | 2013-07-09 |
| 1124461579 | Sarmad Mazin Alyas | Dentist | 37641 Pembroke Ave, Livonia, MI 48152-1050 | 2013-04-16 |
| 1568704468 | Arnold Harry Gartner | Dentist | 1547 W Long Lake Rd, Bloomfield Hills, MI 48302-1342 | 2013-03-19 |
| Find all providers with the same taxonomy | ||||
| City | EAST LANSING |
| Zip Code | 48823 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.