MEDICARE: HEALTHY SMILES DENTAL CARE OF LANSING

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	015703	MI

General Provider Information

NPI Number	:	1275830416
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HEALTHY SMILES DENTAL CARE OF LANSING

Provider Business Mailing Address
First Line	:	2829 E GRAND RIVER AVE
Second Line	:
City	:	LANSING
State	:	MI
Zip	:	48912-4331
Country	:	US
Telephone Number	:	517-333-3160
Fax Number	:	517-333-3166

Provider Business Practice Location Address
First Line	:	2829 E GRAND RIVER AVE
Second Line	:
City	:	LANSING
State	:	MI
Zip	:	48912-4331
Country	:	US
Telephone Number	:	517-333-3160
Fax Number	:	517-333-3166

Authorized Official
Title or Position	:	OWNER
Name	:	DR. STEVEN ROBERT RODRIGUEZ
Credential	:	DDS
Telephone Number	:	734-751-5106

Provider Enumeration Date	:	02/24/2011
Last Update Date	:	02/18/2025

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