Gregory P. Vannucci, DDS

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

07963 Issued in IA

Practice address

1116 Pennsylvania Ave
Ottumwa, IA 52501-2109

Phone

(641) 682-2350

Fax

(641) 683-4616

NPI assigned

Aug 25, 2005

Reactivated

Apr 3, 2006

Sex

Male

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 IA

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

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.

• Gregory P. Vannucci D.D.S.,P.C.

  • Oral and Maxillofacial Surgery (Dentist)
  • Ottumwa, IA
  • NPI 1790969459
  NPD (past) Authorized official
• R. Ian Campbell D.D.S, PLLC

  • Oral and Maxillofacial Surgery (Dentist)
  • Ottumwa, IA
  • NPI 1861066029
  NPD (past)

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

{
    "created_epoch": "1124928000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1366435349",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1116 PENNSYLVANIA AVE",
            "city": "OTTUMWA",
            "state": "IA",
            "postal_code": "525012109",
            "telephone_number": "641-682-2350",
            "fax_number": "641-683-4616"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1116 PENNSYLVANIA AVE",
            "city": "OTTUMWA",
            "state": "IA",
            "postal_code": "525012109",
            "telephone_number": "641-682-2350",
            "fax_number": "641-683-4616"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANNUCCI",
        "first_name": "GREGORY",
        "middle_name": "P.",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-25",
        "last_updated": "2007-07-08",
        "deactivation_date": "2006-03-27",
        "reactivation_date": "2006-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "IA",
            "license": "07963",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Travis Underwood, LISW
• Unity Home Care Solutions LLC
• Janeva Van Haaften, PHARM D
• Heidi Leigh Van Maanen, D.O.
• Suzette Kathryn Van Vark, LMHC, IADC
• Veronica Wells Butler MD PC
• Heather K Voyles, P.T.
• John Timothy Voyles, P.T.
• Tina Kashaun Wade, RN
• Paula Lynn Waite, RPH

• Oral and Maxillofacial Surgery (Dentist) in Ottumwa, IA
• Providers in Ottumwa, IA by specialty
• Oral and Maxillofacial Surgery (Dentist) in Iowa

• 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.