Patrick Vancura

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

34093 Issued in TX

Practice address

4881 Sugar Maple Dr
Wright Patterson AFB, OH 45433-5529

Phone

(512) 422-8057

NPI assigned

Jun 19, 2018

Sex

Male

Sole proprietor

Yes

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 TX

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": "1529366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655337600000",
    "number": "1285128728",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4881 SUGAR MAPLE DR",
            "city": "WRIGHT PATTERSON AFB",
            "state": "OH",
            "postal_code": "454335529"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4881 SUGAR MAPLE DR",
            "city": "WRIGHT PATTERSON AFB",
            "state": "OH",
            "postal_code": "454335529",
            "telephone_number": "512-422-8057"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "101 Plum Creek Ln",
            "address_purpose": "LOCATION",
            "city": "Dripping Springs",
            "state": "TX",
            "postal_code": "786204613",
            "country_code": "US",
            "telephone_number": "512-422-8057",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VANCURA",
        "first_name": "PATRICK",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-06-19",
        "last_updated": "2022-06-16",
        "certification_date": "2022-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "34093",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Thaddaeus M Vaichus
• William Joseph Valko, M.D.
• Richard E Vanarsdel, O.D.
• Anna M Vance, CRNA
• Richard Isaac Vance, DMD
• Anthony Vande Hei, DO
• Daniel Lee Vansyoc, MD
• Thomas Vaughn, PA-C
• Laura Virgo, MD
• Jacqueline Kate Wade, M.D.

• General Practice Dentistry in Wright Patterson AFB, OH
• Providers in Wright Patterson AFB, OH by specialty
• General Practice Dentistry in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2022; 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.