Provider Demographics
NPI:1740248749
Name:LANDI A HELLER DDS
Entity type:Organization
Organization Name:LANDI A HELLER DDS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:LANDI
Authorized Official - Middle Name:ANNE
Authorized Official - Last Name:HELLER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:248-437-2024
Mailing Address - Street 1:505 S LAFAYETTE
Mailing Address - Street 2:
Mailing Address - City:SOUTH LYON
Mailing Address - State:MI
Mailing Address - Zip Code:48178
Mailing Address - Country:US
Mailing Address - Phone:248-437-2024
Mailing Address - Fax:248-437-1924
Practice Address - Street 1:505 S LAFAYETTE
Practice Address - Street 2:
Practice Address - City:SOUTH LYON
Practice Address - State:MI
Practice Address - Zip Code:48178
Practice Address - Country:US
Practice Address - Phone:248-437-2024
Practice Address - Fax:248-437-1924
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI149401223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty