Individual provider Active NPI

Martin F Vanvliet, DMD

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Highland, NY
National Provider Identifier
1356554166
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
License
31621 Issued in NY
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.

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

LicenseStateTypeSpecialty
11843NJMDOrthodontics and Dentofacial Orthopedic Dentist
31621NYMDOrthodontics and Dentofacial Orthopedic Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
Bradford W Ganz, DMD, PLLC Orthodontics and Dentofacial Orthopedics PastSince Oct 20, 2024 Accepting new patients

Specialties & licenses 2

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X 31621 NY Primary
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X 11843 NJ

Addresses

NPPES NPI Registry

Primary 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.

Verify at the official NPI Registry.