Vandalia Dental Associates, LLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

33977917 Issued in IL

Legal business name

VANDALIA DENTAL ASSOCIATES, LLC

Practice address

2219 W Randolph St
Vandalia, IL 62471-1947

Phone

(618) 283-1760

Fax

(618) 283-1657

NPI assigned

Dec 18, 2006

Organization subpart

No

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

Authorized official

Name

John (Jay) Jason Lowry, DMDNPI 1356404867

Title

Owner

Phone

(618) 283-1760

Specialties & licenses 1

Addresses

Locations

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.

• John (Jay) Jason Lowry, DMD

  • General Practice Dentistry
  • Vandalia, IL
  • NPI 1356404867
  NPD (past) Authorized official
• Jonathan Michael Sones, D.M.D

  • General Practice Dentistry
  • Vandalia, IL
  • NPI 1639499791
  NPD (past)

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

{
    "created_epoch": "1166400000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1508929118",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2219 W RANDOLPH ST",
            "city": "VANDALIA",
            "state": "IL",
            "postal_code": "624711947",
            "telephone_number": "618-283-1760",
            "fax_number": "618-283-1657"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2219 W RANDOLPH ST",
            "city": "VANDALIA",
            "state": "IL",
            "postal_code": "624711947",
            "telephone_number": "618-283-1760",
            "fax_number": "618-283-1657"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VANDALIA DENTAL ASSOCIATES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-18",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "LOWRY",
        "authorized_official_first_name": "JOHN (JAY)",
        "authorized_official_middle_name": "JASON",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "618-283-1760",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "33977917",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Darryl Paul Tjaden
• Jessica Dawn Torbeck
• Total Renal Care Inc (Vandalia Dialysis)
• Transforming Physical Therapy LTD (Transforming Physical Therapy & Wellness)
• Vandalia Cusd 203
• Vandalia Estates, LLC
• Vandalia Hco, LLC (Vandalia Rehabilitation & Health Care Center)
• Vandalia Hco, LLC
• Vandalia Healthcare & Senior Living LLC
• Vandalia Physical Therapy LTD (Transforming Physical Therapy)

• General Practice Dentistry in Vandalia, IL
• Providers in Vandalia, 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 Aug 22, 2020; 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.