Derek Vinkovich, D.D.S

Primary specialty

DentistTaxonomy code 122300000X

License

30-024282 Issued in OH

Practice address

6675 Royalton Rd
North Royalton, OH 44133-4927

Phone

(440) 237-3223

NPI assigned

May 5, 2014

Last updated

Jan 31, 2017By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in OH

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

State licenses

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

{
    "created_epoch": "1399248000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1485820800000",
    "number": "1255741872",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1492 HAMPTON KNOLL DR",
            "city": "AKRON",
            "state": "OH",
            "postal_code": "443134839",
            "telephone_number": "440-391-2026"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6675 ROYALTON RD",
            "city": "NORTH ROYALTON",
            "state": "OH",
            "postal_code": "441334927",
            "telephone_number": "440-237-3223"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VINKOVICH",
        "first_name": "DEREK",
        "credential": "D.D.S",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-05-05",
        "last_updated": "2017-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "OH",
            "license": "30-024282",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Beverly A Ulbrich
• Sonya Underwood
• Kia Vantaggi, RPH
• Yvonne Karin Vincent, RN
• Craig E Vinkovich, D.D.S.
• Vitalxchange Inc
• Emad Wasef, FNP-C
• Pamela Magna Whitcomb, LPN
• Alan Blake Wiggers, D.O.
• Genice Marie Williams-Rivers, LPCC

• Dentist in North Royalton, OH
• Providers in North Royalton, OH by specialty
• Dentist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2017; 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.