Active NPI
Gregory John Vanvliet, DENTIST
- General Practice Dentistry
- North Haledon, NJ
National Provider Identifier
1376635128
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- DI1271000
- Practice address
- 33 Sicomac Rd
Suite 202
North Haledon, NJ 07508-2971 - Phone
- (973) 427-0300
- Fax
- (973) 427-7745
- NPI assigned
- Sep 29, 2006
- Sex
- Male
- Sole proprietor
- No
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 | DI1271000 | NJ | Primary |
Addresses
Primary practice location
33 Sicomac Rd
Suite 202
North Haledon, NJ 07508-2971
Mailing address
33 Sicomac Rd
Suite 202
North Haledon, NJ 07508-2971
Phone (973) 427-0300
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DI1271000 | NJ | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159488000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1376635128",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "33 SICOMAC RD",
"address_2": "SUITE 202",
"city": "NORTH HALEDON",
"state": "NJ",
"postal_code": "075082971",
"telephone_number": "973-427-0300",
"fax_number": "973-427-7745"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "33 SICOMAC RD",
"address_2": "SUITE 202",
"city": "NORTH HALEDON",
"state": "NJ",
"postal_code": "075082971",
"telephone_number": "973-427-0300",
"fax_number": "973-427-7745"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VANVLIET",
"first_name": "GREGORY",
"middle_name": "JOHN",
"name_prefix": "Dr.",
"credential": "DENTIST",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-09-29",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "NJ",
"license": "DI1271000",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in North Haledon, NJ
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.