Roger Allan Vander Beek, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

MI 10580 Issued in MI

Practice address

3060 W Centre Ave
Portage, MI 49024-4825

Phone

(269) 327-5730

Fax

(269) 327-3156

NPI assigned

Dec 11, 2006

Sex

Male

Sole proprietor

Yes

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

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1165795200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1114087418",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3060 W CENTRE AVE",
            "city": "PORTAGE",
            "state": "MI",
            "postal_code": "490244825",
            "telephone_number": "269-327-5730",
            "fax_number": "269-327-3156"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3060 W CENTRE AVE",
            "city": "PORTAGE",
            "state": "MI",
            "postal_code": "490244825",
            "telephone_number": "269-327-5730",
            "fax_number": "269-327-3156"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANDER BEEK",
        "first_name": "ROGER",
        "middle_name": "ALLAN",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-11",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "MI 10580",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Yelba Yelitza Pineda Vallecillo, BCBA
• Ray Christian Van de Walker, D.C.
• Anthony J Van Es, MD
• Lillian R Van Gelderen
• Nathan Douglas Van Hofwegen, D.D.S.
• Dan J Vandermeulen, DDS MS
• Mark Vandermyde
• Ciara Vanderploeg, PHD
• Kenneth M Vandervelde Jr., MD
• Susan Vandewalker, P.T.

• General Practice Dentistry in Portage, MI
• Providers in Portage, MI by specialty
• General Practice Dentistry in Michigan

• 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.