Deborah Van, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

106509 Issued in CA

Practice address

5729 Nutwood Cir
Simi Valley, CA 93063-3566

Phone

(805) 297-5035

NPI assigned

Jul 21, 2021

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 CA

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

Practice roles

Locations

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.

• Fulbright Dental Group, PC

  • General Practice Dentistry
  • Los Angeles, CA
  • NPI 1336384619
  Medicare reassignment NPD
• Lumina Healthcare, LLC

  • General Practice Dentistry
  • Los Angeles, CA
  • NPI 1932343589
  NPD (past)

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

{
    "created_epoch": "1626825600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626825600000",
    "number": "1336712074",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5729 NUTWOOD CIR",
            "city": "SIMI VALLEY",
            "state": "CA",
            "postal_code": "930633566",
            "telephone_number": "805-297-5035"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5729 NUTWOOD CIR",
            "city": "SIMI VALLEY",
            "state": "CA",
            "postal_code": "930633566",
            "telephone_number": "805-297-5035"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAN",
        "first_name": "DEBORAH",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-07-21",
        "last_updated": "2021-07-21",
        "certification_date": "2021-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "106509",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Oscar E Vallejo, OT
• Valley Hospice Services LLC
• Valley Pacific Hospice, Inc.
• Stephen Philip Vampola, MD
• Judy Van Der Wende, PH.D.
• Kenneth Francis Van, OD
• Kevin Van
• Patricia Lynn Vanbuskirk, MA, MFT
• Ann Taylor Vance, PH.D.
• Brooke Celia Vanover, LCSW

• Dentist in Simi Valley, CA
• Providers in Simi Valley, CA by specialty
• Dentist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2021; 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.