Individual provider Active NPI

James Robert Vandre, DDS

  • Dentist
  • Burlington, NC
National Provider Identifier
1053398842
Registry record updated Aug 14, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
9351 Issued in NC
Practice address
3008 S Church Street
#B
Burlington, NC 27215
Phone
(336) 584-7004
NPI assigned
Dec 22, 2005
Last updated
Aug 14, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 14, 2012

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 13843 MD
Dentist 122300000X DD3354 NM
Dentist 122300000X 9351 NC Primary

Addresses

Primary practice location

3008 S Church Street
#B
Burlington, NC 27215

Mailing address

3008 S Church Street
#B
Burlington, NC 27215
Phone (336) 584-7004

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20150516000169 NC Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 6305166216

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
13843MDMDClinical Social Worker
9351NCMDDentist
DD3354NMMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Mary Lynne McElhaney, DDS 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1135209600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1344902400000",
    "number": "1053398842",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3008 S CHURCH STREET",
            "address_2": "#B",
            "city": "BURLINGTON",
            "state": "NC",
            "postal_code": "27215",
            "telephone_number": "336-584-7004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3008 S CHURCH STREET",
            "address_2": "#B",
            "city": "BURLINGTON",
            "state": "NC",
            "postal_code": "27215",
            "telephone_number": "336-584-7004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANDRE",
        "first_name": "JAMES",
        "middle_name": "ROBERT",
        "name_prefix": "Mr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-22",
        "last_updated": "2012-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MD",
            "license": "13843",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NM",
            "license": "DD3354",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NC",
            "license": "9351",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Burlington, NC

Sources for this page

Verify at the official NPI Registry.