Vanidestine Chiropractic, Inc

Primary specialty

ChiropractorTaxonomy code 111N00000X

Legal business name

VANIDESTINE CHIROPRACTIC, INC

Practice address

336 Mount Hope Ave Ste 11
Bangor, ME 04401-4236

Phone

(207) 942-2800

Fax

(207) 990-2632

NPI assigned

Jan 10, 2019

Organization subpart

No

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

Authorized official

Name

Dr. Thomas J Vanidestine Jr., D.C.

Title

Owner

Phone

(207) 942-2800

Specialties & licenses 1

Addresses

Other names 1

• VANIDESTINE CHIROPRACTIC Doing business as

Locations

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

{
    "created_epoch": "1547078400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1547078400000",
    "number": "1174096309",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "336 MOUNT HOPE AVE STE 11",
            "city": "BANGOR",
            "state": "ME",
            "postal_code": "044014236",
            "telephone_number": "207-942-2800",
            "fax_number": "207-990-2632"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "336 MOUNT HOPE AVE STE 11",
            "city": "BANGOR",
            "state": "ME",
            "postal_code": "044014236",
            "telephone_number": "207-942-2800",
            "fax_number": "207-990-2632"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VANIDESTINE CHIROPRACTIC, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-01-10",
        "last_updated": "2019-01-10",
        "status": "A",
        "authorized_official_last_name": "VANIDESTINE",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "207-942-2800",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "VANIDESTINE CHIROPRACTIC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Timothy Douglas Van Sickle
• John F Vanadia, DO
• Vance a Aloupis Mdpa
• Vance a. Aloupis MD PA
• Lori Vandeventer
• Thomas J Vanidestine Jr., DC, CCSP
• Ellen Vanvranken
• Julian Albert Varona
• Jill Ann Vaughn, NP
• Jody Veillette, CADC

• Chiropractor in Bangor, ME
• Providers in Bangor, ME by specialty
• Chiropractor in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2019; 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.