Gregory Shawn Vance, DMD

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

7630 Issued in KY

Practice address

3285 Blazer Pkwy
Suite 210
Lexington, KY 40509-2119

Phone

(859) 264-1854

Fax

(859) 264-1855

NPI assigned

Sep 28, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in KY

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

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1159401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1205927696",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3285 BLAZER PKWY",
            "address_2": "SUITE 210",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405092119",
            "telephone_number": "859-264-1854",
            "fax_number": "859-264-1855"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3285 BLAZER PKWY",
            "address_2": "SUITE 210",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405092119",
            "telephone_number": "859-264-1854",
            "fax_number": "859-264-1855"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANCE",
        "first_name": "GREGORY",
        "middle_name": "SHAWN",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-28",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "KY",
            "license": "7630",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Robert Ritchie Vanbussum, MD
• Jessika Cordell Vance-Morgan, BCBA
• Adrianne Rose Vance, PA
• Andi Alexandria Vance, APRN
• Gabriel C Vance
• John Charles Vance, MD
• Justyce Vancleve, RBT
• Joshua Lee Vandeburgh, MD
• Cassidy Vandepol, RBT
• Sean Joseph Vander Woude

• Periodontics in Lexington, KY
• Providers in Lexington, KY by specialty
• Periodontics in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.