DR. LARRY WALLACE MIZELLE (NPI# 1760670491) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1760670491 |
| Entity Type | Individual |
| Full Name | DR. LARRY WALLACE MIZELLE |
| Credential | DDS |
| Practice Address |
7298 Jackman Rd Temperance MI 48182-1313 |
| Practice Telephone | 7348476350 |
| Practice Fax Number | 7348479217 |
| Mailing Telephone | 7348476350 |
| Mailing Fax Number | 7348479217 |
| Enumeration Date | 2007-10-09 |
| Last Update Date | 2007-10-09 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
10910 | MI | Dental Providers |
| Street Address |
7298 JACKMAN RD |
| City | TEMPERANCE |
| State | MI |
| Zip Code | 48182-1313 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699938589 | Liberty Corners Dental Pllc | Dentist | 7298 Jackman Rd, Temperance, MI 48182-1313 | 2008-07-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982186771 | Ruben J Loo | Physical Therapist | 2000 W. Dean Road, Temperance, MI 48182 | 2018-08-29 |
| 1356881460 | Chelsea Engler | Licensed Practical Nurse | 22230 Camille, Temperance, MI 48182 | 2017-03-08 |
| 1801252291 | Charles Dean Tabbert | Nurse Anesthetist, Certified Registered | 3661 Saint Anthony Rd, Temperance, MI 48182 | 2016-01-14 |
| 1023360229 | Tamara Ruth Ciha | Technician, Other | 1070 North Park Dr, Temperance, MI 48182 | 2012-10-11 |
| 1356651004 | Meghanne Denise Decant | Registered Nurse | 2128 W Rauch Rd, Temperance, MI 48182 | 2010-10-15 |
| 1639325202 | Joanne Marie Segura | Licensed Practical Nurse | 6711 Summerfield, Temperance, MI 48182 | 2008-08-14 |
| 1952564775 | Kaye Cecelia Shepherd | Home Health Aide | 3346 St Anthony Road, Temperance, MI 48182 | 2008-07-02 |
| 1467638494 | Aspen Ridge, LLC | Skilled Nursing Facility | 951 Hickory Creek Blvd., Temperance, MI 48182 | 2008-01-22 |
| 1144406703 | Liberty Compounding Pharmacy, LLC | Pharmacy | 7355 Lewis Ave, Suite D, Temperance, MI 48182 | 2008-01-14 |
| 1760698724 | Rebecca Ann Pasko | Counselor | 9035 Lewis Ave, Temperance, MI 48182 | 2007-05-15 |
| Find all providers in zip 48182 | ||||
| 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 |
|---|---|---|---|---|
| 1497835284 | Debra S. Reiner | Dentist | 8339 Lewis Ave, Temperance, MI 48182-9285 | 2006-10-16 |
| 1598244949 | Crystal Ann Schafer | Dentist | 8339 Lewis Ave, Temperance, MI 48182-9285 | 2018-08-07 |
| 1619241692 | Ahmed Mahboob Syeda | Dentist | 8765 Lewis Ave, Temperance, MI 48182-9583 | 2012-03-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336749522 | Berman Family Dentistry Pllc | Dentist | 9430 S Main St Ste 1, Plymouth, MI 48170-4149 | 2020-10-28 |
| 1821696956 | Dream Dental Group Pllc | Dentist | 9600 Commerce Rd, Commerce Twp, MI 48382-4111 | 2020-10-12 |
| 1629675020 | Superior Family Dental | Dentist | 425 W Huron St Ste 140, Milford, MI 48381-2243 | 2020-10-08 |
| 1255948790 | Jamie L Hafke Dds Pllc | Dentist | 1955 N Pontiac Trl, Walled Lake, MI 48390-3157 | 2020-09-29 |
| 1942817812 | Maria Edith Cserhalmi | Dentist | 20618 Harper Ave., Harper Woods, MI 48225-1429 | 2020-09-25 |
| 1649886748 | Advanced Family Dentistry-plymouth Pllc | Dentist | 44644 Ann Arbor Rd W Ste F, Plymouth, MI 48170-4089 | 2020-09-23 |
| 1396351045 | Sandra Alias | Dentist | 27828 Westcott Crescent Cir, Farmington Hills, MI 48334-5314 | 2020-09-18 |
| 1265047641 | Michigan Implant Dental Center | Dentist | 28701 Plymouth Rd Ste B, Livonia, MI 48150-2421 | 2020-09-11 |
| 1366057929 | Dr. Leigh Ellen Snyder Dds | Dentist | 16869 E 14 Mile Rd, Fraser, MI 48026-2239 | 2020-09-10 |
| 1215541305 | Kevin P Cooper Dds PC | Dentist | 202 Brady Street, Sault Sainte Marie, MI 49783 | 2020-09-04 |
| Find all providers with the same taxonomy | ||||
| City | TEMPERANCE |
| Zip Code | 48182 |
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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.