Angela Vredenburg, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

2901016958 Issued in MI

Practice address

1510 N Broadway St
Hastings, MI 49058-1007

Phone

(269) 945-3358

NPI assigned

May 15, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

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

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

{
    "created_epoch": "1179187200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1326254277",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2487 STURBRIDGE DR SE",
            "city": "ADA",
            "state": "MI",
            "postal_code": "493018363"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1510 N BROADWAY ST",
            "city": "HASTINGS",
            "state": "MI",
            "postal_code": "490581007",
            "telephone_number": "269-945-3358"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VREDENBURG",
        "first_name": "ANGELA",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-15",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "2901016958",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sarah E Verburg, FNP
• Vicki L Shumaker PLC
• Ashley Villegas
• Julie Viviano, MS OTR/L
• Wesley P Von Seggern, DO
• Wal-Mart Stores East LP
• Callan J Walcott, CFNP
• Walgreen Co
• Gretchen Walsh
• Eric E. Ward, M.D.

• General Practice Dentistry in Hastings, MI
• Providers in Hastings, MI by specialty
• General Practice Dentistry in Michigan

• 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.
• 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.