Van Sicklen DDS Inc

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

VAN SICKLEN DDS INC

Practice address

1372 W Robinhood Dr Ste a
Stockton, CA 95207-5513

Phone

(209) 607-6956

NPI assigned

Jun 26, 2021

Organization subpart

No

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

Authorized official

Name

Dr. Charles Neal Van Sicklen, DDSNPI 1629489315

Title

Ceo

Phone

(209) 607-6956

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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

• Charles Vansicklen, DDS

  • Student in an Organized Health Care Education/Training Program
  • Stockton, CA
  • NPI 1629489315
  NPD Authorized official

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

{
    "created_epoch": "1624665600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1626220800000",
    "number": "1205406915",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9591 RUFF AVE",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952122417",
            "telephone_number": "209-607-6956"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1372 W ROBINHOOD DR STE A",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952075513",
            "telephone_number": "209-607-6956"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VAN SICKLEN DDS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-06-26",
        "last_updated": "2021-07-14",
        "certification_date": "2021-07-14",
        "status": "A",
        "authorized_official_last_name": "VAN SICKLEN",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "NEAL",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "209-607-6956",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christine Marie Van Horn, MD, MS
• Krystal Van Houten
• Jennilee Keshet Van Nes, MFT ASSOCIATE
• Breanna Van Pernis
• Van Pharmacy
• Alexandra Van Zuyen
• Shylah Vanasse
• Vance Marriage and Family Therapy, Inc.
• Carole Marie Vance, LMFT
• Roanne Vander Veen

• Dental Clinic/Center in Stockton, CA
• Providers in Stockton, CA by specialty
• Dental Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2021; 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.