William Shane Vaughn, D.M.D.

Primary specialty

DentistTaxonomy code 122300000X

License

22193 Issued in FL

Practice address

2113 Sarno Rd
Melbourne, FL 32935

Phone

(321) 259-9429

NPI assigned

Jun 30, 2015

Last updated

Sep 2, 2016By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

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: No
• Hospice: Yes

Green means eligible to order or refer.

Opted out of Medicare

Previously, effective Sep 13, 2016 through Sep 13, 2026

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1435622400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1472774400000",
    "number": "1467835074",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2113 SARNO RD",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "32935",
            "telephone_number": "321-259-9429"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2113 SARNO RD",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "32935",
            "telephone_number": "321-259-9429"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAUGHN",
        "first_name": "WILLIAM",
        "middle_name": "SHANE",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-06-30",
        "last_updated": "2016-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "KY",
            "license": "9626",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "22193",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Laura Vasallo, A.P., L.M.T.
• Julie Vasiliadis
• Dax Vasiliou, O.D.
• Elizabeth C Vasser, M.D.
• Muraiha Rose Vaughn, CPM, LM
• Rayna A Vause, PA-C
• Sabrina Vazquez Campos
• Isabella Vazquez
• Johnny J Vazquez, M.D.
• Shakayla Vecchione

• Dentist in Melbourne, FL
• Providers in Melbourne, FL by specialty
• Dentist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2016; 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.