VDP Rochester LLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

VDP ROCHESTER LLC

Practice address

1329 Main St
Rochester, IN 46975-2107

Phone

(574) 223-3121

Fax

(574) 406-8136

NPI assigned

May 24, 2023

Organization subpart

No

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

Authorized official

Name

Aricka Ulery

Title

Practice Manager

Phone

(574) 223-3121

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Implant and Cosmetic Dentistry Doing business as

Locations

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

{
    "created_epoch": "1684886400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1684886400000",
    "number": "1033801469",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1329 MAIN ST",
            "city": "ROCHESTER",
            "state": "IN",
            "postal_code": "469752107",
            "telephone_number": "574-223-3121",
            "fax_number": "574-406-8136"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1329 MAIN ST",
            "city": "ROCHESTER",
            "state": "IN",
            "postal_code": "469752107",
            "telephone_number": "574-223-3121",
            "fax_number": "574-406-8136"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VDP ROCHESTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-05-24",
        "last_updated": "2023-05-24",
        "certification_date": "2023-05-24",
        "status": "A",
        "authorized_official_last_name": "ULERY",
        "authorized_official_first_name": "ARICKA",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "574-223-3121"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DENTIST",
            "identifier": "1922016260",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DENTIST",
            "identifier": "1154715324",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Implant and Cosmetic Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Elizabeth Ann Thomas, MA CCC-SLP
• Tura Thompson, BA
• Letecia D Timmel, MSW, LCSW
• Trinity Healthcare, Inc.
• Thomas O Troutman, O.D.
• Vista Hospice Care LLC
• Wal-Mart Stores East LP
• Walgreen Co
• David A. Walker, LCSW
• Deborah Jean Webb, BGS

• General Practice Dentistry in Rochester, IN
• Providers in Rochester, IN by specialty
• General Practice Dentistry in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.