Active NPI
Vaune M Wenzinger, GENERAL DENTIST
- Dentist
- Camas, WA
National Provider Identifier
1003960808
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 4993
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 531246 | Other | WA | UNITED 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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20150309002584 | WA | Order and Referring Only - Oral Surgery | 2961728985 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4993 | WA | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New 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.
-
- General Practice Dentistry
- Camas, WA
- NPI 1861884983
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.