Richard Mark Vanburk, D.M.D.

Primary specialty

DentistTaxonomy code 122300000X

License

019016797 Issued in IL

Practice address

610 N Logan Ave
Danville, IL 61832-4321

Phone

(217) 442-3385

Fax

(217) 442-2517

NPI assigned

Nov 5, 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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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 and National Provider Directory roles.

• Richard M. Vanburk, D.M.D., P.C.

  • Dentist
  • Danville, IL
  • NPI 1205180577
  NPD (past) Authorized official

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

{
    "created_epoch": "1162684800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1209600000000",
    "number": "1154400588",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "610 N LOGAN AVE",
            "city": "DANVILLE",
            "state": "IL",
            "postal_code": "618324321",
            "telephone_number": "217-442-3385",
            "fax_number": "217-442-2517"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "610 N LOGAN AVE",
            "city": "DANVILLE",
            "state": "IL",
            "postal_code": "618324321",
            "telephone_number": "217-442-3385",
            "fax_number": "217-442-2517"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANBURK",
        "first_name": "RICHARD",
        "middle_name": "MARK",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-05",
        "last_updated": "2008-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": "019016797",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1004069",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Dentist in Danville, IL
• Providers in Danville, IL by specialty
• Dentist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2008; 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.