Individual provider Active NPI

David R Vogelsang, DDS

  • General Practice Dentistry
  • Fargo, ND
National Provider Identifier
1295945657
Registry record updated May 17, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
1581 Issued in ND
Practice address
3003 32ND Ave S
Suite 3
Fargo, ND 58103-6163
Phone
(701) 318-3614
NPI assigned
May 23, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 17, 2014

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 1581 ND Primary

Addresses

Primary practice location

3003 32ND Ave S
Suite 3
Fargo, ND 58103-6163

Mailing address

3537 River Dr S
Fargo, ND 58104-6217
Phone (701) 318-3614

Other identifiers 2

IdentifierTypeStateIssuer
41244MedicaidND
949661OtherNDBC/BS NORTH DAKOTA DENTAL

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

NPI Registry JSON

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

{
    "created_epoch": "1179878400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1400284800000",
    "number": "1295945657",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3537 RIVER DR S",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581046217",
            "telephone_number": "701-318-3614"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3003 32ND AVE S",
            "address_2": "SUITE 3",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581036163",
            "telephone_number": "701-318-3614"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VOGELSANG",
        "first_name": "DAVID",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-23",
        "last_updated": "2014-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "ND",
            "license": "1581",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "41244",
            "state": "ND"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS NORTH DAKOTA DENTAL",
            "identifier": "949661",
            "state": "ND"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fargo, ND

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2014; 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.