Elizabeth Viruet, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

D12878 Issued in MN

Practice address

218 Quarterman St
Waycross, GA 31501-3547

Phone

(912) 287-0301

Fax

(912) 287-1568

NPI assigned

Oct 17, 2008

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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in SC

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

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 and National Provider Directory roles.

• McKinney Community Health Ctr, Inc

  • Federally Qualified Health Center (FQHC)
  • Blackshear, GA
  • NPI 1568623346
  NPD (past)

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

{
    "created_epoch": "1224201600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1470614400000",
    "number": "1326290644",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "218 QUARTERMAN ST",
            "city": "WAYCROSS",
            "state": "GA",
            "postal_code": "315013547",
            "telephone_number": "912-287-0301",
            "fax_number": "912-287-1568"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "218 QUARTERMAN ST",
            "city": "WAYCROSS",
            "state": "GA",
            "postal_code": "315013547",
            "telephone_number": "912-287-0301",
            "fax_number": "912-287-1568"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VIRUET",
        "first_name": "ELIZABETH",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-10-17",
        "last_updated": "2016-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MN",
            "license": "D12878",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003145286A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Dillon Todd Veal, PA-C
• Meredith Gaines Veal, PA-C
• Eduardo Jose Venegas, M.D.
• Stephanie Lynn Vick, FNP-C
• Jose Ramon Villamil, M.D.
• Vita Bridge LLC
• Volunteers of America of Georgia
• Jason Ted Wade, PHARMD
• Robert Keath Wade, MD
• Sandra Kaye Wade, RPH

• Dentist in Waycross, GA
• Providers in Waycross, GA by specialty
• Dentist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2016; 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.