Active NPI
Richard Vangurp, DDS PLLC
- General Practice Dentistry
- Charlotte, NC
National Provider Identifier
1437283330
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 5645
- Practice address
- 3111 Springbank LN Ste F
Charlotte, NC 28226-3373 - Phone
- (704) 542-2884
- NPI assigned
- Mar 15, 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 | 5645 | NC | Primary |
Addresses
Primary practice location
3111 Springbank LN Ste F
Charlotte, NC 28226-3373
Mailing address
337 Kindling Wood LN
Marvin, NC 28173-6802
Phone (704) 843-2272
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NC
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20180724004147 | NC | Order and Referring Only - Dentist | 3779735196 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5645 | NC | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1173916800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1492560000000",
"number": "1437283330",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "337 KINDLING WOOD LN",
"city": "MARVIN",
"state": "NC",
"postal_code": "281736802",
"telephone_number": "704-843-2272"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3111 SPRINGBANK LN STE F",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282263373",
"telephone_number": "704-542-2884"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VANGURP",
"first_name": "RICHARD",
"name_prefix": "Dr.",
"credential": "DDS PLLC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-03-15",
"last_updated": "2017-04-19",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "NC",
"license": "5645",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Charlotte, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2017; 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.