S. Michael Vancil, D.M.D.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

019-017293 Issued in IL

Practice address

1255 Cedar CT
Carbondale, IL 62901-5335

Phone

(618) 529-3931

Fax

(618) 529-1011

NPI assigned

Jul 30, 2008

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Yes, effective Feb 12, 2015 through Feb 12, 2027

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Smichael Vancil DMD LLC

  • Public Health Dentistry
  • Carbondale, IL
  • NPI 1770632119
  NPD (past)

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

{
    "created_epoch": "1217376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1217376000000",
    "number": "1487810461",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1255 CEDAR CT",
            "city": "CARBONDALE",
            "state": "IL",
            "postal_code": "629015335",
            "telephone_number": "618-529-3931",
            "fax_number": "618-529-1011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1255 CEDAR CT",
            "city": "CARBONDALE",
            "state": "IL",
            "postal_code": "629015335",
            "telephone_number": "618-529-3931",
            "fax_number": "618-529-1011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANCIL",
        "first_name": "S. MICHAEL",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-07-30",
        "last_updated": "2008-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019-017293",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CORPORATE NPI",
            "identifier": "1770632119",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Unity Point School
• Unity Point School Admin
• University Correctional Health Care Solutions LLC
• Unlimited Development, Inc
• Satyanarayana Rao Vaidya, MD
• Kandy M Vanderkooi, LMT
• Eugenio Fortunato Vargas, MD
• Terry A Varvil, NBC-HIS
• Bonnie T Vaughn, RH.D
• Harold Todd Vaughn, P.T.

• General Practice Dentistry in Carbondale, IL
• Providers in Carbondale, IL by specialty
• General Practice Dentistry in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2008; 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.