LIFETIME DENTAL CARE OF MICHIGAN, P.C. (NPI# 1922500917) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1922500917 |
| Entity Type | Organization |
| Organization Name | LIFETIME DENTAL CARE OF MICHIGAN, P.C. |
| Other Organization Name | WOLF CREEK DENTAL |
| Practice Address |
1136 Country Club Rd Ste B Adrian MI 49221-8208 |
| Practice Telephone | 5172639022 |
| Mailing Telephone | 5172639022 |
| Enumeration Date | 2018-03-06 |
| Last Update Date | 2018-03-06 |
| Authorized Official Name | CASSANDRA PETERSEN (CREDENTIALING TEAM LEAD) |
| Authorized Official Telephone | 2175408972 |
| Is Organization Subpart | Y |
| Parent Organization Name | LIFETIME DENTAL CARE OF MICHIGAN, P.C. |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
Dental Providers |
| Other Name | Type Code |
|---|---|
| Wolf Creek Dental | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720620594 | Lifetime Dental Care of Michigan, P.C. | Dentist | 56060 Van Dyke Ave, Shelby Township, MI 48316-5143 | 2019-10-14 |
| 1053952382 | Lifetime Dental Care of Michigan, P.C. | Dentist | 102 W Highland Rd, Howell, MI 48843-1159 | 2019-10-08 |
| 1295241313 | Lifetime Dental Care of Michigan, P.C. | Dentist | 20793 Farmington Rd Ste 201, Farmington Hills, MI 48336-5182 | 2017-12-27 |
| 1891848594 | Lifetime Dental Care of Michigan, P.C. | Dentist | 19249 Allen Rd, Brownstown Twp, MI 48183-1189 | 2007-01-18 |
| 1568515278 | Lifetime Dental Care of Michigan, P.C. | Dentist | 1820 Whittaker Rd, Ypsilanti, MI 48197-9728 | 2007-01-18 |
| 1285110650 | Lifetime Dental Care of Michigan, P.C. | Dentist | 1950 Chesley Dr, Sterling Heights, MI 48310-4817 | 2018-07-18 |
| 1174032932 | Lifetime Dental Care of Michigan, P.C. | Dentist | 4912 W St Joe Hwy, Lansing, MI 48917-4090 | 2017-09-25 |
| Street Address |
1136 COUNTRY CLUB RD STE B |
| City | ADRIAN |
| State | MI |
| Zip Code | 49221-8208 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285116723 | Sandra Ann Harsh | Occupational Therapist | Total Rehab, 1136 Country Club, Adrian, MI 49221 | 2018-08-31 |
| 1588156178 | Chelsea Varney | Social Worker | 1040 Winter Street, Adrian, MI 49221 | 2018-05-31 |
| 1669974127 | Nicoletta Mary Bruno | Physical Therapy Assistant | 700 Lakeshire Trail, Adrian, MI 49221 | 2018-03-01 |
| 1871011403 | Evan Splan | Pharmacist | 1200 South Main St Suite A, Adrian, MI 49221 | 2017-09-04 |
| 1780104992 | Daniel Malcolm | Specialist/Technologist | 1325 Williams St., Adrian, MI 49221 | 2017-06-20 |
| 1639602881 | Robert Gargol | Pharmacist | 1535 W Maumee, Adrian, MI 49221 | 2017-04-05 |
| 1487196416 | Painless Dentistry V | Dentist | 160 N. Winter St., Adrian, MI 49221 | 2016-11-08 |
| 1487025227 | Michelle Lynn Ranta | Speech-Language Pathologist | 730 Kimole Ln., Adrian, MI 49221 | 2015-10-19 |
| 1376929109 | James Hamblin | Technician, Other | 1100 South Main St. Lot 139, Adrian, MI 49221 | 2015-08-04 |
| 1316320039 | Shirley Goodlock | Community/Behavioral Health | 3091 E. Carleton Rd, Adrian, MI 49221 | 2015-06-30 |
| Find all providers in zip 49221 | ||||
| Taxonomy Code | 1223G0001X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | General Practice |
| A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. |
| Notes: Source: Academy of General Dentistry |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326569260 | Michigan Dental Associates - Adrian PC | Dentist | 160 N Winter St, Adrian, MI 49221-2093 | 2017-06-30 |
| 1730618612 | Michelle Skaff | Dentist | 113 Maine Ave, Adrian, MN 56110-1192 | 2017-06-05 |
| 1528595501 | Scott Robert Gibson | Dentist | 1515 E Us Highway 223, Adrian, MI 49221-4456 | 2017-05-22 |
| 1487196416 | Painless Dentistry V | Dentist | 160 N. Winter St., Adrian, MI 49221 | 2016-11-08 |
| 1437549425 | Dr. Eldib, Pllc | Dentist | 1515 E Us Highway 223 Ste G, Adrian, MI 49221-4456 | 2015-01-28 |
| 1265876619 | Robert Howard Love IIi | Dentist | 689 Stockford Dr, Adrian, MI 49221-1460 | 2013-04-28 |
| 1457658163 | Gary A Blaesing Dds PC | Dentist | 1548 West Maumee, Adrian, MI 49221 | 2011-02-15 |
| 1740503648 | Brilliant Smiles Dental/vabo Investments Pllc | Dentist | 113 W Front St Ste C, Adrian, MI 49221-2072 | 2010-03-05 |
| 1346456332 | Richard B. Youngs,dds,pc | Dentist | 133 E Maple Ave, Adrian, MI 49221-2157 | 2007-05-15 |
| 1578786034 | Lenawee Dental Clinic Inc | Dentist | 128 S Broad St, Adrian, MI 49221-2723 | 2007-04-11 |
| Find all providers in ADRIAN | ||||
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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.