Active NPI
Martin F Vanvliet, DMD
- Orthodontics and Dentofacial Orthopedics Dentistry
- Highland, NY
National Provider Identifier
1356554166
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthodontics and Dentofacial Orthopedics Dentistry
- License
- 31621
- Practice address
- 19 Woodside PL
Highland, NY 12528-1413 - Phone
- (845) 691-8330
- Fax
- (845) 691-7019
- NPI assigned
- May 8, 2007
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
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.
-
- Orthodontics and Dentofacial Orthopedics Dentistry
- Highland, NY
- NPI 1235959446
Orthodontics and Dentofacial Orthopedics
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11843 | NJ | MD | Orthodontics and Dentofacial Orthopedic Dentist |
| 31621 | NY | MD | Orthodontics and Dentofacial Orthopedic Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Bradford W Ganz, DMD, PLLC | Orthodontics and Dentofacial Orthopedics | Past | Accepting new patients |
Specialties & licenses 2
NPPES NPI Registry| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthodontics and Dentofacial Orthopedics Dentistry | 1223X0400X | 31621 | NY | Primary |
| Orthodontics and Dentofacial Orthopedics Dentistry | 1223X0400X | 11843 | NJ |
Addresses
NPPES NPI RegistryPrimary practice location
19 Woodside PL
Highland, NY 12528-1413
Mailing address
19 Woodside PL
Highland, NY 12528-1413
Phone (845) 691-8330
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jul 8, 2007.
{
"created_epoch": "1178582400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1356554166",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "19 WOODSIDE PL",
"city": "HIGHLAND",
"state": "NY",
"postal_code": "125281413",
"telephone_number": "845-691-8330",
"fax_number": "845-691-7019"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "19 WOODSIDE PL",
"city": "HIGHLAND",
"state": "NY",
"postal_code": "125281413",
"telephone_number": "845-691-8330",
"fax_number": "845-691-7019"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VANVLIET",
"first_name": "MARTIN",
"middle_name": "F",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-05-08",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223X0400X",
"taxonomy_group": "",
"desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
"state": "NY",
"license": "31621",
"primary": true
},
{
"code": "1223X0400X",
"taxonomy_group": "",
"desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
"state": "NJ",
"license": "11843",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Highland, NY
Sources for this page
- 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.