Individual provider Active NPI

Jeffrey T Vasko, D.M.D.

  • General Practice Dentistry
  • Warner Robins, GA
National Provider Identifier
1295828440
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
011290 Issued in GA
Practice address
100 S Houston Rd
Warner Robins, GA 31088-3904
Phone
(478) 929-1661
Fax
(478) 929-1219
NPI assigned
Oct 2, 2006
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 011290 GA Primary

Addresses

Primary practice location

100 S Houston Rd
Warner Robins, GA 31088-3904

Mailing address

102 Fernwood Dr
Warner Robins, GA 31088-6180
Phone (478) 929-1661

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
011290GAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Plantation Family Dentalcare General Practice Current Accepting new patients
Joseph T. Sumrall, Jr., D.M.D., P.C. Jeffrey T. Vasko, D.M.D. General Practice Past Accepting new patients

Locations

1859 Savage Rd
Charleston, SC 29407
Phone (843) 722-5733

Interoperability endpoints

  • Direct secure messaging: jvasko435661@direct.musc.edu

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1159747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1295828440",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "102 FERNWOOD DR",
            "city": "WARNER ROBINS",
            "state": "GA",
            "postal_code": "310886180",
            "telephone_number": "478-929-1661",
            "fax_number": "478-929-1219"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 S HOUSTON RD",
            "city": "WARNER ROBINS",
            "state": "GA",
            "postal_code": "310883904",
            "telephone_number": "478-929-1661",
            "fax_number": "478-929-1219"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VASKO",
        "first_name": "JEFFREY",
        "middle_name": "T",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-02",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "GA",
            "license": "011290",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Warner Robins, GA

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.