Wenona B Van Derhei, DDS

Primary specialty

ProsthodonticsTaxonomy code 1223P0700X

License

DN011854 Issued in GA

Practice address

3590 Braselton Hwy Ste 103
Dacula, GA 30019-1120

Phone

(678) 318-3353

Fax

(678) 318-3350

NPI assigned

Oct 5, 2006

Sex

Female

Sole proprietor

No

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.

• Van Derhei Implant and Prosthetics

  • Dental Clinic/Center
  • Dacula, GA
  • NPI 1710281795
  NPD (past)

Medicare fee-for-service enrollment

Enrolled in GA

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

Practice roles

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

Specialties & licenses 2

Addresses

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

{
    "created_epoch": "1160006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1342656000000",
    "number": "1285720144",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3590 BRASELTON HWY STE 103",
            "city": "DACULA",
            "state": "GA",
            "postal_code": "300191120",
            "telephone_number": "678-318-3353",
            "fax_number": "678-318-3350"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3590 BRASELTON HWY STE 103",
            "city": "DACULA",
            "state": "GA",
            "postal_code": "300191120",
            "telephone_number": "678-318-3353",
            "fax_number": "678-318-3350"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAN DERHEI",
        "first_name": "WENONA",
        "middle_name": "B",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-05",
        "last_updated": "2012-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "GA",
            "license": "DN011854",
            "primary": false
        },
        {
            "code": "1223P0700X",
            "taxonomy_group": "",
            "desc": "Dentist, Prosthodontics",
            "state": "GA",
            "license": "DN011854",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• David Franklin Uhry, DC
• Ultiwellness Solutions
• US Home Care Agency, Inc.
• Van Derhei Implant and Prosthetics
• Van Derhei Implant Prosthetics Dental LLC
• Patrick Vanderhei, DDS, MSD
• Mykolas Varkalis, DMD
• Rolandine Vaughan, PAC
• Rabia Lynne Vaughns, PA-C
• Victory Eyecare LLC

• All providers in Dacula, GA
• Prosthodontics in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2012; 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.