DR. LISANDRA SOTO CASILLAS (NPI# 1720081219) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1720081219 |
| Entity Type | Individual |
| Full Name | DR. LISANDRA SOTO CASILLAS |
| Other Name | DR. LISANDRA SOTO |
| Credential | D.M.D |
| Practice Address |
3299 Gull Rd Room G-5, Kchcsd- Dental Clinic Kalamazoo MI 49048-1281 |
| Mailing Address |
364 Tuscany Dr Portage MI 49024-9110 |
| Practice Telephone | 2693735228 |
| Practice Fax Number | 2693735176 |
| Mailing Telephone | 2693247653 |
| Mailing Fax Number | 2693247653 |
| Enumeration Date | 2005-05-27 |
| Last Update Date | 2016-03-14 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223P0221X |
Dentist Specialization: Pediatric Dentistry |
2901017305 | MI | Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | 1720081219 | 05 |
| Street Address |
3299 GULL RD ROOM G-5, KCHCSD- DENTAL CLINIC |
| City | KALAMAZOO |
| State | MI |
| Zip Code | 49048-1281 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942279815 | Douglas Homnick | Pediatrics | 3299 Gull Rd, Kalamazoo, MI 49048-1281 | 2006-03-14 |
| 1356899629 | Family Health Center, Inc. | Clinic/Center | 3299 Gull Rd, Room G- 5, Kalamazoo, MI 49048-1281 | 2016-09-15 |
| 1194185603 | Norma Steinhardt Bour | Dietitian, Registered | 3299 Gull Rd, Kalamazoo, MI 49048-1281 | 2016-02-25 |
| 1912301698 | Sarah Fry | Case Manager/Care Coordinator | 3299 Gull Rd, Kalamazoo, MI 49048-1281 | 2014-10-09 |
| 1235567967 | Sara Newland | Registered Nurse | 3299 Gull Rd, Kalamazoo, MI 49048-1281 | 2013-10-15 |
| 1093056392 | Julie Ann Morris | Dental Hygienist | 3299 Gull Rd, Wing 1, Room G5, Kalamazoo, MI 49048-1281 | 2013-03-12 |
| 1407197254 | Leslie Sue Timmerman | Dental Hygienist | 3299 Gull Rd, W1 G5, Kalamazoo, MI 49048-1281 | 2013-03-04 |
| 1457699332 | Kalamazoo Community Mental Health and Substance Abuse Services | Case Management | 3299 Gull Rd, Kalamazoo, MI 49048-1281 | 2013-01-28 |
| 1477815645 | Kalamazoo Community Mental Health and Substance Abuse Services | Community/Behavioral Health | 3299 Gull Rd, W1f4, Kalamazoo, MI 49048 | 2012-06-13 |
| 1457582827 | Jorie M Harris | Dentist | 3299 Gull Rd, Kalamazoo, MI 49048-1281 | 2009-08-04 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790214146 | Sally Leigh Weigandt | Technician, Other | 5438 Lucerne Ave, Kalamazoo, MI 49048 | 2017-06-08 |
| 1437606670 | Amanda Ezekiel | Advanced Practice Midwife | 1523 Gull Rd Ste 250, Kalamazoo, MI 49048 | 2016-09-06 |
| 1700238987 | Brittany Bittenbender | Technician, Other | 5840 E Cork St, Kalamazoo, MI 49048 | 2016-07-12 |
| 1255747176 | Araena Payton | Early Intervention Provider Agency | 1313 Hotop Ave, Kalamazoo, MI 49048 | 2014-07-11 |
| 1508297151 | Hope Network Eastwood House | Residential Treatment Facility, Physical Disabilities | 2236 Brook Drive, Kalamazoo, MI 49048 | 2013-12-09 |
| 1457780314 | Hope Network Rehabilitation Servicesq | Residential Treatment Facility, Physical Disabilities | 2236 Brooke Drive, Kalamazoo, MI 49048 | 2013-11-01 |
| 1467889576 | Aaron Van Heest | Social Worker | 813 Chrysler St., Kalamazoo, MI 49048 | 2013-10-03 |
| 1760737308 | Salem A. Salem | Internal Medicine | Ascension Borgess Hospital, 1521 Gull Rd, Kalamazoo, MI 49048 | 2012-07-19 |
| 1356523229 | Borgess Medical Center | Psychiatry & Neurology | 1521 Gull Road, Kalamazoo, MI 49048 | 2007-12-03 |
| 1629290135 | Robert Claude Gano | Dentist | 5462 Gull Rd Suite 7, Kalamazoo, MI 49048 | 2007-05-03 |
| Find all providers in zip 49048 | ||||
| Taxonomy Code | 1223P0221X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Pediatric Dentistry |
| An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295146413 | Kalamazoo Pediatric Dentistry | Dentist | 1900 Whites Rd, Kalamazoo, MI 49008-2872 | 2014-05-09 |
| 1851354120 | Thomas Lee Owen | Dentist | 1900 Whites Rd, Kalamazoo, MI 49008 | 2006-04-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033717558 | Discover Smiles Pediatric Dentistry | Dentist | 2277 Science Pkwy Ste 2, Okemos, MI 48864-2551 | 2020-10-16 |
| 1740898873 | Megan E Stowers Dds Ms Plc | Dentist | 7459 Middlebelt Rd Ste 1, West Bloomfield, MI 48322-4184 | 2020-07-15 |
| 1447884069 | Jocelyn M. Robelli Dds, Ms, Pllc | Dentist | 18245 E 10 Mile Rd Ste 110, Roseville, MI 48066-5807 | 2020-02-24 |
| 1457914038 | Mitten Kids Dentistry Caledonia Plc | Dentist | 6477 Cherry Meadow Dr Se Ste 4, Caledonia, MI 49316-7351 | 2019-04-18 |
| 1780143982 | Childrens Dental Specialists of Hazel Park Pllc | Dentist | 22241 John R Rd, Hazel Park, MI 48030-1716 | 2019-03-18 |
| 1487128120 | Dental Group Associates PC | Dentist | 4505 Cascade Rd Se # B, Grand Rapids, MI 49546-8381 | 2019-01-16 |
| 1184194433 | Pediatric Dental Specialists of West Michigan | Dentist | 2155 E Paris Ave Se Ste 120, Grand Rapids, MI 49546-6142 | 2018-11-29 |
| 1811465990 | Kingma Pediatric Dentistry Pllc | Dentist | 1179 E Paris Ave Se Ste 130, Grand Rapids, MI 49546-3682 | 2018-11-07 |
| 1407322548 | Great Lakes Bay Pediatric Dentistry, Plc | Dentist | 5605 Colony Dr N Ste 2, Saginaw, MI 48638-7187 | 2018-10-16 |
| 1063987725 | Little Red Pediatric Dentistry, Plc | Dentist | 12723 N Bellwood Dr Ste 20, Holland, MI 49424-7275 | 2018-10-09 |
| Find all providers with the same taxonomy | ||||
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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.