Individual provider Active NPI

Vaune M Wenzinger, GENERAL DENTIST

  • Dentist
  • Camas, WA
National Provider Identifier
1003960808
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
4993 Issued in WA
Practice address
531 NE Everett St
Camas, WA 98607
Phone
(360) 834-4990
Fax
(360) 834-3424
NPI assigned
Jan 22, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 4993 WA Primary

Addresses

Primary practice location

531 NE Everett St
Camas, WA 98607

Mailing address

531 NE Everett St
Camas, WA 98607
Phone (360) 834-4990

Other identifiers 1

IdentifierTypeStateIssuer
531246OtherWAUNITED CONCORDIA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150309002584 WA Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 2961728985

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4993WAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Northwest Oral Health PC Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1169424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1003960808",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "531 NE EVERETT ST",
            "city": "CAMAS",
            "state": "WA",
            "postal_code": "98607",
            "telephone_number": "360-834-4990",
            "fax_number": "360-834-3424"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "531 NE EVERETT ST",
            "city": "CAMAS",
            "state": "WA",
            "postal_code": "98607",
            "telephone_number": "360-834-4990",
            "fax_number": "360-834-3424"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WENZINGER",
        "first_name": "VAUNE",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "GENERAL DENTIST",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-22",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WA",
            "license": "4993",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED CONCORDIA",
            "identifier": "531246",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Camas, WA

Sources for this page

Verify at the official NPI Registry.