David Shane Verschueren, D.M.D, M.D.

Primary specialty

Oral & Maxillofacial Surgery (D.M.D.)Taxonomy code 204E00000X

License

MD60071474 Issued in WA

Practice address

601 SE 117TH Ave Ste 120
Vancouver, WA 98683-5297

Phone

(360) 695-4300

Fax

(360) 695-4344

NPI assigned

Jun 11, 2007

Sex

Male

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Apr 5, 2017 through Apr 5, 2027

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1181520000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1248220800000",
    "number": "1447454954",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 SE 117TH AVE STE 120",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986835297",
            "telephone_number": "360-695-4300",
            "fax_number": "360-695-4344"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 SE 117TH AVE STE 120",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986835297",
            "telephone_number": "360-695-4300",
            "fax_number": "360-695-4344"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VERSCHUEREN",
        "first_name": "DAVID",
        "middle_name": "SHANE",
        "credential": "D.M.D, M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-06-11",
        "last_updated": "2009-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "204E00000X",
            "taxonomy_group": "",
            "desc": "Oral & Maxillofacial Surgery",
            "state": "WA",
            "license": "MD60071474",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• David Pavlovich Vergulyanets, PT, DPT.
• Darienne Marie Veri, LMHP
• Simone Lucia Vernez, M.D.
• Charles James Verro, MA, LMHC
• Versa Force LLC
• Molly P Verschuyl, PT
• Aron Dwain Versteeg, CDP
• Travis Joseph Vertuca
• Andyi M Veruca
• Kristy Veruca

• Oral & Maxillofacial Surgery (D.M.D.) in Vancouver, WA
• Providers in Vancouver, WA by specialty
• Oral & Maxillofacial Surgery (D.M.D.) in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2009; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.