NPIMap

Organization Active NPI

Van-Dao, Inc

  • General Practice Dentistry
  • Oklahoma City, OK
National Provider Identifier
1154739381
Registry record updated Jul 31, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
OK5132 Issued in OK
Legal business name
VAN-DAO, INC
Practice address
12321 Hidden Forest Blvd
Oklahoma City, OK 73142-2578
Phone
(405) 722-7767
Fax
(405) 722-8858
NPI assigned
Jul 31, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 31, 2014

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

Authorized official

Name
Dr. Mark R Vandenberg, DDS
Title
Owner
Phone
(405) 722-7767

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223G0001X OK5132 OK Primary

Addresses

Primary practice location

12321 Hidden Forest Blvd
Oklahoma City, OK 73142-2578

Mailing address

12321 Hidden Forest Blvd
Oklahoma City, OK 73142-2578
Phone (405) 722-7767

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1406764800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1406764800000",
    "number": "1154739381",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12321 HIDDEN FOREST BLVD",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731422578",
            "telephone_number": "405-722-7767",
            "fax_number": "405-722-8858"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12321 HIDDEN FOREST BLVD",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731422578",
            "telephone_number": "405-722-7767",
            "fax_number": "405-722-8858"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VAN-DAO, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-07-31",
        "last_updated": "2014-07-31",
        "status": "A",
        "authorized_official_last_name": "VANDENBERG",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "405-722-7767",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "OK",
            "license": "OK5132",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2014; 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.