NPIMap

Organization Active NPI

Douglas Vandermeulen DDS PLLC

  • General Practice Dentistry
  • Marshall, MI
National Provider Identifier
1447574314
Registry record updated Mar 22, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
13841 Issued in MI
Legal business name
DOUGLAS VANDERMEULEN DDS PLLC
Practice address
207 Winston Dr
Marshall, MI 49068-8526
Phone
(269) 781-6300
Fax
(269) 781-8459
NPI assigned
Mar 22, 2010
Last updated
Mar 22, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 22, 2010

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

Authorized official

Name
Douglas Alan Vandermeulen, DDSNPI 1255411096
Title
Dentist
Phone
(269) 781-6300

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 13841 MI Primary

Addresses

Primary practice location

207 Winston Dr
Marshall, MI 49068-8526

Mailing address

207 Winston Dr
Marshall, MI 49068-8526
Phone (269) 781-6300

National Provider Directory

National Provider Directory

Locations

207 Winston Dr
Marshall, MI 49068
Phone (269) 781-6300

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1269216000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1269216000000",
    "number": "1447574314",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "207 WINSTON DR",
            "city": "MARSHALL",
            "state": "MI",
            "postal_code": "490688526",
            "telephone_number": "269-781-6300",
            "fax_number": "269-781-8459"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "207 WINSTON DR",
            "city": "MARSHALL",
            "state": "MI",
            "postal_code": "490688526",
            "telephone_number": "269-781-6300",
            "fax_number": "269-781-8459"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DOUGLAS VANDERMEULEN DDS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-03-22",
        "last_updated": "2010-03-22",
        "status": "A",
        "authorized_official_last_name": "VANDERMEULEN",
        "authorized_official_first_name": "DOUGLAS",
        "authorized_official_middle_name": "ALAN",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "269-781-6300",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "13841",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marshall, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2010; 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.