Individual provider Active NPI

David Paul Vanslambrouck, D.D.S.

  • Dentist
  • Kalamazoo, MI
National Provider Identifier
1215255542
Registry record updated Jan 20, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
016.0066669 Issued in VT
Practice address
2918 Portage St
Kalamazoo, MI 49001-3755
Phone
(269) 349-2641
NPI assigned
May 11, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 20, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 016.0066669 VT Primary

Addresses

Primary practice location

2918 Portage St
Kalamazoo, MI 49001-3755

Mailing address

2918 Portage St
Kalamazoo, MI 49001-3755
Phone (269) 349-2641

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20160928000913 MI Order and Referring Only - DentistPractitioner - Dentist 5294038154

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
016.0066669VTMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Family Health Center Inc Current Accepting new patients

Locations

117 W Paterson St
Kalamazoo, MI 49007

2918 Portage St
Kalamazoo, MI 49001

Organizations & group practices 1

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": "1273536000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1453248000000",
    "number": "1215255542",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2918 PORTAGE ST",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490013755",
            "telephone_number": "269-349-2641"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2918 PORTAGE ST",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490013755",
            "telephone_number": "269-349-2641"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANSLAMBROUCK",
        "first_name": "DAVID",
        "middle_name": "PAUL",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-05-11",
        "last_updated": "2016-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "VT",
            "license": "016.0066669",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kalamazoo, MI

Sources for this page

Verify at the official NPI Registry.