Individual provider Active NPI

Marvin Calvin Vore, D.D.S.

  • General Practice Dentistry
  • Hudson, IA
National Provider Identifier
1275616971
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
6468 Issued in IA
Practice address
107 Eldora Road
Hudson, IA 50643-0277
Phone
(319) 988-4131
Fax
(319) 988-4132
NPI assigned
Oct 24, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 6468 IA Primary

Addresses

Primary practice location

107 Eldora Road
Hudson, IA 50643-0277

Mailing address

107 Eldora Road
P.O. Box 277
Hudson, IA 50643-0277
Phone (319) 988-4131

Other identifiers 1

IdentifierTypeStateIssuer
0161315MedicaidIA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
6468IAMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1161648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1275616971",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "107 ELDORA ROAD",
            "address_2": "P.O. BOX 277",
            "city": "HUDSON",
            "state": "IA",
            "postal_code": "506430277",
            "telephone_number": "319-988-4131",
            "fax_number": "319-988-4132"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 ELDORA ROAD",
            "city": "HUDSON",
            "state": "IA",
            "postal_code": "506430277",
            "telephone_number": "319-988-4131",
            "fax_number": "319-988-4132"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VORE",
        "first_name": "MARVIN",
        "middle_name": "CALVIN",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-24",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IA",
            "license": "6468",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0161315",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hudson, IA

Sources for this page

  • 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.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.