Active NPI
David A. Varland, D.D.S.
- General Practice Dentistry
- Rockford, IL
National Provider Identifier
1225098304
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 019-017691
- Practice address
- 6068 Palo Verde Dr
Rockford, IL 61114-8116 - Phone
- (815) 877-3264
- Fax
- (815) 877-3294
- NPI assigned
- Mar 24, 2006
- Last updated
- Dec 20, 2011
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 019-017691 | IL | Primary |
Addresses
Primary practice location
6068 Palo Verde Dr
Rockford, IL 61114-8116
Mailing address
6068 Palo Verde Dr
Rockford, IL 61114-8116
Phone (815) 877-3264
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0000012079 | Other | IL | BLUE CROSS BLUE SHIELD PROVIDER NUMBER |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
- Opted out of Medicare
- Yes, effective Nov 28, 2006 through Nov 28, 2026
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 019-017691 | IL | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Rock Valley Center for Snoring & Sleep Apnea | Past | Accepting new patients |
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Customized Equipment (DME)
- Rockford, IL
- NPI 1861776254
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1143158400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1324339200000",
"number": "1225098304",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6068 PALO VERDE DR",
"city": "ROCKFORD",
"state": "IL",
"postal_code": "611148116",
"telephone_number": "815-877-3264",
"fax_number": "815-877-3294"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6068 PALO VERDE DR",
"city": "ROCKFORD",
"state": "IL",
"postal_code": "611148116",
"telephone_number": "815-877-3264",
"fax_number": "815-877-3294"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VARLAND",
"first_name": "DAVID",
"middle_name": "A.",
"credential": "D.D.S.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-03-24",
"last_updated": "2011-12-20",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "IL",
"license": "019-017691",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD PROVIDER NUMBER",
"identifier": "0000012079",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Rockford, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2011; 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; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.