Terrence L Vandiver

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DN012433 Issued in GA

Practice address

1631 Gordon Hwy
#22
Augusta, GA 30906-2292

Phone

(706) 790-9302

Fax

(706) 790-9303

NPI assigned

Feb 18, 2006

Last updated

Mar 26, 2015By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Barton Chapel Dental Group, LLC

  • General Practice Dentistry
  • Augusta, GA
  • NPI 1255969432
  NPD Authorized official
• Augusta Smiles Youth Dentistry, PC

  • General Practice Dentistry
  • Augusta, GA
  • NPI 1033184643
  NPD (past)
• Bridgeport River Dental PC

  • General Practice Dentistry
  • Augusta, GA
  • NPI 1346898293
  NPD (past)

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

{
    "created_epoch": "1140220800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1427328000000",
    "number": "1306811914",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1631 GORDON HWY",
            "address_2": "#22",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309062292",
            "telephone_number": "706-790-9302",
            "fax_number": "706-790-9303"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1631 GORDON HWY",
            "address_2": "#22",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309062292",
            "telephone_number": "706-790-9302",
            "fax_number": "706-790-9303"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANDIVER",
        "first_name": "TERRENCE",
        "middle_name": "L",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-18",
        "last_updated": "2015-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "GA",
            "license": "DN012433",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "SC",
            "license": "3827",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DENTAQUEST",
            "identifier": "9180178",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED CONCORDIA",
            "identifier": "2670243",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "747629278A",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ZX3827",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Juliana Van Alstine
• Jennifer M Van Vlerah, NP
• Kayla Van Winkle
• Andrew Louis Vanalstine, M.D.
• Kewanda Vandiver, MS
• Jason Mitchel Vanlandingham, PHARMD
• Jessica Vargas-Arriaga
• Jocelyn Justina Vargas, RBT
• Santosh C Varkey, MD
• Varnell Gaines DMD PC

• General Practice Dentistry in Augusta, GA
• Providers in Augusta, GA by specialty
• General Practice Dentistry in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2015; 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.