PLASTIC SURGERY ARTS OF WEST MICHIGAN
NPI 1467641373
Plastic Surgery in Holland, MI

Q: What is Lakeshore Plastic And Reconstructive Surgery Associates, P.C.'s specialty?

The primary specialty registered for this NPI is Plastic Surgery with taxonomy code 208200000X.

Active since October 16, 2007CLIA 23D1041484 · Waiver

3124 N WELLNESS DRIVE, SUITE 10, HOLLAND, MI 49424(616) 738-5870(616) 738-5872 Get Directions Write a Review

NPPES record last updated: July 21, 2022. Verified against the NPPES registry weekly; last sync: October 25, 2026.

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About Plastic Surgery Arts Of West Michigan NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

PLASTIC SURGERY ARTS OF WEST MICHIGAN (NPI 1467641373) is a healthcare organization registered as a plastic surgery in Holland, Michigan and active in the NPI registry since October 2007. The organization holds a CLIA Waiver certificate valid through June 5, 2027 and lists Ryan E Dodde, President, as its authorized official.

NPPES Registry Identity

NPI1467641373

Entity TypeOrganization

Primary Taxonomy208200000X

Legal Business NameLAKESHORE PLASTIC AND RECONSTRUCTIVE SURGERY ASSOCIATES, P.C.

Location Address3124 N WELLNESS DRIVE, SUITE 10Holland, MI 49424-8121

Mailing Address3124 N Wellness Drive, Suite 10Holland, MI 49424-8121 · (616) 738-5870 · Fax (616) 738-5872

Phone(616) 738-5870

Fax(616) 738-5872

Organization SubpartNo

Authorized OfficialRyan E DoddePresident · (616) 738-5870

Enumeration DateOctober 16, 2007

Last NPPES UpdateJuly 21, 2022

✔ NPI 1467641373 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPlastic SurgeryAllopathic & Osteopathic Physicians

Taxonomy Code208200000X

Definition

A plastic surgeon deals with the repair, reconstruction or replacement of physical defects of form or function involving the skin, musculoskeletal system, craniomaxillofacial structures, hand, extremities, breast and trunk and external genitalia or cosmetic enhancement of these areas of the body. Cosmetic surgery is an essential component of plastic surgery. The plastic surgeon uses cosmetic surgical principles to both improve overall appearance and to optimize the outcome of reconstructive procedures. The surgeon uses aesthetic surgical principles not only to improve undesirable qualities of normal structures but in all reconstructive procedures as well.

3124 N WELLNESS DRIVE, Holland, MI 49424

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Other Names 1

Doing Business AsPlastic Surgery Arts Of West Michigan

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross Blue Shield of Michigan Mutual Insurance Company.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Plastic Surgery Arts Of West Michigan is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Plastic Surgery Arts Of West Michigan, which bills Medicare for the services this clinician delivers.

Clinician (1)

Ryan Dodde, M.D.

Plastic and Reconstructive Surgery

NPI 1881669299

3124 N WELLNESS DR SUITE 10
Holland, MI 49424

(616) 738-5870

✔ PECOS✔ Accepts MedicareSame address

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 23D1041484

Plastic Surgery Arts Of West Michigan · Holland, MI

Active · expires Jun 5, 2027

CLIA Number23D1041484

Laboratory TypeAmbulatory Surgery Center

Certificate Effective DateJune 6, 2025

Certificate Expiration DateJune 5, 2027

Laboratory DirectorRyan E. Dodde II

Laboratory Phone(616) 738-5870

Laboratory LocationPlastic Surgery Arts Of West Michigan3124 N Wellness Drive Suite 10, Holland, MI 49424

CLIA data matches this NPI record on: Address Name Phone

This certificate is issued to a laboratory to perform only waived tests.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Lakeshore Plastic And Reconstructive Surgery Associates, P.C.'s NPI number?

The NPI number for Lakeshore Plastic And Reconstructive Surgery Associates, P.C. is 1467641373. It was assigned to this organization in the NPPES registry on October 16, 2007. The provider is doing business as Plastic Surgery Arts Of West Michigan.

Where is Lakeshore Plastic And Reconstructive Surgery Associates, P.C. located?

Lakeshore Plastic And Reconstructive Surgery Associates, P.C. is located at 3124 N Wellness Drive Suite 10, Holland, MI 49424. The listed phone number is (616) 738-5870.

What is Lakeshore Plastic And Reconstructive Surgery Associates, P.C.'s specialty?

The primary specialty registered for this NPI is Plastic Surgery with taxonomy code 208200000X.

Is Lakeshore Plastic And Reconstructive Surgery Associates, P.C. enrolled in Medicare?

Yes. Lakeshore Plastic And Reconstructive Surgery Associates, P.C. is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Lakeshore Plastic And Reconstructive Surgery Associates, P.C.?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Plastic and Reconstructive Surgery) reassigns their Medicare billing to Lakeshore Plastic And Reconstructive Surgery Associates, P.C.. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Lakeshore Plastic And Reconstructive Surgery Associates, P.C. hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 23D1041484) is associated with this NPI, valid through June 5, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Lakeshore Plastic And Reconstructive Surgery Associates, P.C. accept?

Health plans from Blue Cross Blue Shield of Michigan Mutual Insurance Company list Lakeshore Plastic And Reconstructive Surgery Associates, P.C. as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Lakeshore Plastic And Reconstructive Surgery Associates, P.C. was last updated on July 21, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.