Douglas Alan Vonkaenel, D.D.S.

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

30.022741 Issued in OH

Practice address

568 Industrial Pkwy
Heath, OH 43056-1528

Phone

(740) 477-8544

NPI assigned

Sep 22, 2006

Last updated

Apr 17, 2013By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Jan 19, 2023 through Jan 19, 2027

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• East Columbus Oral Surgery Specialists Inc.

  dba East Columbus Oral Surgery Specialists

  • Oral & Maxillofacial Surgery (D.M.D.)
  • Columbus, OH
  • NPI 1831543701
  NPD (past) Authorized official
• Oral & Maxillofacial Surgery Centers Inc

  • Oral and Maxillofacial Surgery (Dentist)
  • Heath, OH
  • NPI 1407028095
  NPD (past)

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

{
    "created_epoch": "1158883200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1366156800000",
    "number": "1083713408",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "568 INDUSTRIAL PKWY",
            "city": "HEATH",
            "state": "OH",
            "postal_code": "430561528",
            "telephone_number": "740-477-8544"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "568 INDUSTRIAL PKWY",
            "city": "HEATH",
            "state": "OH",
            "postal_code": "430561528",
            "telephone_number": "740-477-8544"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VONKAENEL",
        "first_name": "DOUGLAS",
        "middle_name": "ALAN",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-22",
        "last_updated": "2013-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "OH",
            "license": "30.022741",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cheryl Todd
• Melissa Rae Trego
• Alexis Trevorrow, DC
• Deborah Turley, CNP-BC
• Meghann J Varner Lewis
• Wal-Mart Stores East LP (Walmart Pharmacy 10-1594)
• Wal-Mart Stores East, LP (Vision Center 30-1594)
• Walgreen Co (Walgreens #10810)
• Jennifer Warnock, ATC
• Jeannine M Washer, PHARMD

• Oral and Maxillofacial Surgery (Dentist) in Heath, OH
• Providers in Heath, OH by specialty
• Oral and Maxillofacial Surgery (Dentist) in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.