Vermont Technical College Department of Denta

Key facts

NPI

1134473218

Entity type

Organization (NPI type 2)

Primary specialty

General Practice Dentistry 1223G0001X

Legal business name

VERMONT TECHNICAL COLLEGE DEPARTMENT OF DENTA

Practice address

301 Lawrence Place
Williston, VT 05495

Phone

(802) 879-5643

Fax

(802) 879-2317

NPI assigned

Oct 29, 2012

Organization subpart

No

Authorized official

Name

Dr. Ellen B Grimes NPI 1588186662

Title

Department Chair

Phone

(802) 879-5643

Authorized official NPPES reports the authorized official by name only; the link goes to the one practitioner connected to this organization with that name.

Corporate family (same tax ID) 2

Organizations that report the same tax identification number in the National Provider Directory.

• Johnson State College Student Health Clinic/Center · Johnson, VT · NPI 1871719781
  NPD tax ID
• Vermont State Colleges Family Medicine Physician · Lyndonville, VT · NPI 1760601256
  NPD tax ID

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Ellen B Grimes, RDH, ED.D Dental Hygienist · Williston, VT · NPI 1588186662
  NPD (past) Authorized official
• Sheila Catherine Bannister, RDH Dental Hygienist · Williston, VT · NPI 1538395280
  NPD (past)

National Provider Directory

Tax ID family

Johnson State College (3 organizations share this tax ID)

Locations

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Mar 18, 2014.

{
    "created_epoch": "1351468800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1395100800000",
    "number": "1134473218",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 LAWRENCE PLACE",
            "city": "WILLISTON",
            "state": "VT",
            "postal_code": "05495",
            "telephone_number": "802-879-5643",
            "fax_number": "802-879-2317"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 LAWRENCE PLACE",
            "city": "WILLISTON",
            "state": "VT",
            "postal_code": "05495",
            "telephone_number": "802-879-5643",
            "fax_number": "802-879-2317"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VERMONT TECHNICAL COLLEGE DEPARTMENT OF DENTA",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-10-29",
        "last_updated": "2014-03-18",
        "status": "A",
        "authorized_official_last_name": "GRIMES",
        "authorized_official_first_name": "ELLEN",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "DEPARTMENT CHAIR",
        "authorized_official_telephone_number": "802-879-5643",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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All providers in Williston, VT · General Practice Dentistry in Vermont