Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Lakehsore Otolaryngology

Organization Facial Plastic Surgery Physician · NPI 1770696379

Lakehsore Otolaryngology is a Facial Plastic Surgery Physician in Holland, Michigan. Registered with an NPI since 2006.

In the registry since
2006

Practice location Address checks out

577 Michigan Ave Ste 101
Holland, MI 49423
Phone: (616) 393-2190
Fax: (616) 393-0147
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Facial Plastic Surgery Physician (primary) Taxonomy 207YS0123X

Record details

NPI number1770696379
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Theodore Vanderveen — President · (616) 393-2190
NPI enumeratedAugust 16, 2006
Last updated in NPPESAugust 22, 2020
Mailing address577 Michigan Avenue, Suite 101, Holland, MI 49423