Active NPI
Richard K. Vann, D.M.D.
- Pediatric Dentistry
- Montgomery, AL
National Provider Identifier
1285743872
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Dentistry
- License
- 3068
- Practice address
- 7015 Halcyon Park Dr
Montgomery, AL 36117-7763 - Phone
- (334) 284-1100
- Fax
- (334) 281-1245
- NPI assigned
- Aug 29, 2006
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Pediatric Dentistry | 1223P0221X | 3068 | AL | Primary |
Addresses
Primary practice location
7015 Halcyon Park Dr
Montgomery, AL 36117-7763
Mailing address
7015 Halcyon Park Dr
Montgomery, AL 36117-7763
Phone (334) 284-1100
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 009921645 | Medicaid | AL | |
| 51515480 | Other | AL | BCBS PROVIDER NUMBER |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 3068 | AL | MD | Marriage & Family Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Dentists 4 Children, L.L.C. | Pediatric Dentistry | 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 and National Provider Directory roles.
-
- Pediatric Dentistry
- Montgomery, AL
- NPI 1861501454
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156809600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1285743872",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7015 HALCYON PARK DR",
"city": "MONTGOMERY",
"state": "AL",
"postal_code": "361177763",
"telephone_number": "334-284-1100",
"fax_number": "334-281-1245"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7015 HALCYON PARK DR",
"city": "MONTGOMERY",
"state": "AL",
"postal_code": "361177763",
"telephone_number": "334-284-1100",
"fax_number": "334-281-1245"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VANN",
"first_name": "RICHARD",
"middle_name": "K.",
"name_prefix": "Dr.",
"credential": "D.M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-29",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0221X",
"taxonomy_group": "",
"desc": "Dentist, Pediatric Dentistry",
"state": "AL",
"license": "3068",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "009921645",
"state": "AL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS PROVIDER NUMBER",
"identifier": "51515480",
"state": "AL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Montgomery, AL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 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.