Individual provider Active NPI

Allyson McHugh Van, DDS

  • Dentist
  • Boynton Beach, FL
National Provider Identifier
1205314556
Registry record updated Sep 7, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DN23575 Issued in FL
Practice address
1790 N Congress Ave Ste 100
Boynton Beach, FL 33426-8268
Phone
(561) 572-3555
NPI assigned
Jul 30, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 7, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DN23575 FL Primary

Addresses

Primary practice location

1790 N Congress Ave Ste 100
Boynton Beach, FL 33426-8268

Mailing address

1030 Audace Ave Apt 105
Boynton Beach, FL 33426-3385

Other practice location 1

5796 S University Dr Ste 102
Davie, FL 33328-6119
Phone (954) 248-2742

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20181030001977 FL Order and Referring Only - DentistPractitioner - Dentist 6901159458

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Davie Modern Dentistry, PA Past Accepting new patients
Sage Dental of Central Boynton Beach, PLLC Dentist PastSince Sep 12, 2021 Accepting new patients

Networks

  • Freedom Health HMO Network

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1532908800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630972800000",
    "number": "1205314556",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1030 AUDACE AVE APT 105",
            "city": "BOYNTON BEACH",
            "state": "FL",
            "postal_code": "334263385"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1790 N CONGRESS AVE STE 100",
            "city": "BOYNTON BEACH",
            "state": "FL",
            "postal_code": "334268268",
            "telephone_number": "561-572-3555"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5796 S University Dr Ste 102",
            "address_purpose": "LOCATION",
            "city": "Davie",
            "state": "FL",
            "postal_code": "333286119",
            "country_code": "US",
            "telephone_number": "954-248-2742",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCHUGH VAN",
        "first_name": "ALLYSON",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-07-30",
        "last_updated": "2021-09-07",
        "certification_date": "2021-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "DN23575",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boynton Beach, FL

Sources for this page

Verify at the official NPI Registry.