Active NPI
David P Vanpeursem, D.D.S.
- General Practice Dentistry
- San Anselmo, CA
National Provider Identifier
1366653743
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 23794
- Practice address
- 508 Red Hill Ave
San Anselmo, CA 94960-2436 - Phone
- (415) 457-2244
- Fax
- (415) 457-3562
- NPI assigned
- May 25, 2007
- Last updated
- Jul 8, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 23794 | CA | Primary |
Addresses
Primary practice location
508 Red Hill Ave
San Anselmo, CA 94960-2436
Mailing address
508 Red Hill Ave
San Anselmo, CA 94960-2436
Phone (415) 457-2244
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| B23794-01 | Other | CA | DENTI-CAL |
| 500569 | Other | CA | UNITED CONCORDIA INS |
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 |
|---|---|---|---|
| 23794 | CA | MD | Clinical Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| David P Van Peursem DDS a Professional Corporation | General Practice | Past | Accepting new patients |
| Dr. Brooks Dental Corp | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- General Practice Dentistry
- San Anselmo, CA
- NPI 1427172832
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1180051200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1366653743",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "508 RED HILL AVE",
"city": "SAN ANSELMO",
"state": "CA",
"postal_code": "949602436",
"telephone_number": "415-457-2244",
"fax_number": "415-457-3562"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "508 RED HILL AVE",
"city": "SAN ANSELMO",
"state": "CA",
"postal_code": "949602436",
"telephone_number": "415-457-2244",
"fax_number": "415-457-3562"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VANPEURSEM",
"first_name": "DAVID",
"middle_name": "P",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-05-25",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "CA",
"license": "23794",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DENTI-CAL",
"identifier": "B23794-01",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED CONCORDIA INS",
"identifier": "500569",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in San Anselmo, CA
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.