Myorthos Vermont Orthodontics PC

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

Legal business name

MYORTHOS VERMONT ORTHODONTICS PC

Doing business as

Champlain Orthodontics

Practice address

277 Blair Park Rd Ste 101
Williston, VT 05495-7885

Phone

(802) 878-5323

NPI assigned

Nov 13, 2023

Organization subpart

Yes

Parent organization

MYORTHOS VERMONT ORTHODONTICS PCAs reported in NPPES

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Casey Lonabocker

Title

VP Operations & Strategy

Phone

(617) 535-3364

Specialties & licenses 1

Addresses

Other names 1

• Champlain Orthodontics Doing business as

Part of

Myorthos Vermont Orthodontics PC

Locations

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

{
    "created_epoch": "1699833600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1732060800000",
    "number": "1407620214",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "131 DARTMOUTH ST FL 3",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021165297",
            "telephone_number": "617-665-7241"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "277 BLAIR PARK RD STE 101",
            "city": "WILLISTON",
            "state": "VT",
            "postal_code": "054957885",
            "telephone_number": "802-878-5323"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "80 Mapleville Depot",
            "address_purpose": "LOCATION",
            "city": "Saint Albans",
            "state": "VT",
            "postal_code": "054781857",
            "country_code": "US",
            "telephone_number": "802-527-7100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MYORTHOS VERMONT ORTHODONTICS PC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MYORTHOS VERMONT ORTHODONTICS PC",
        "enumeration_date": "2023-11-13",
        "last_updated": "2024-11-20",
        "certification_date": "2024-11-20",
        "status": "A",
        "authorized_official_last_name": "LONABOCKER",
        "authorized_official_first_name": "CASEY",
        "authorized_official_title_or_position": "VP OPERATIONS & STRATEGY",
        "authorized_official_telephone_number": "617-535-3364"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Champlain Orthodontics",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Champlain Orthodontics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Orthodontics and Dentofacial Orthopedics Dentistry in Williston, VT
• Providers in Williston, VT by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in Vermont

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2024; 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.