Active NPI
Vincent G Dauchess, D.D.S.
- Specialist
- Pottsville, PA
National Provider Identifier
1528030954
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- DS018834-L
- Practice address
- 401 W Market St
Pottsville, PA 17901-2930 - Phone
- (570) 622-2036
- Fax
- (570) 622-5242
- NPI assigned
- Feb 1, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | DS018834-L | PA | Primary |
Addresses
Primary practice location
401 W Market St
Pottsville, PA 17901-2930
Mailing address
401 W Market St
Pottsville, PA 17901-2930
Phone (570) 622-2036
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0160922 | Other | PA | KEYSTONE |
| 0005170230001 | Medicaid | PA | |
| 160922 | Other | PA | BLUE SHIELD MEDICAL |
| 01176001 | Other | PA | CAPITAL BLUE CROSS |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DS018834-L | PA | MD | Specialist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Vincent G. Dauchess, D.D.S, P.C | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Oral and Maxillofacial Surgery (Dentist)
- Pottsville, PA
- NPI 1538239256
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1138752000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1528030954",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "401 W MARKET ST",
"city": "POTTSVILLE",
"state": "PA",
"postal_code": "179012930",
"telephone_number": "570-622-2036",
"fax_number": "570-622-5242"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "401 W MARKET ST",
"city": "POTTSVILLE",
"state": "PA",
"postal_code": "179012930",
"telephone_number": "570-622-2036",
"fax_number": "570-622-5242"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAUCHESS",
"first_name": "VINCENT",
"middle_name": "G",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-02-01",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "PA",
"license": "DS018834-L",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "KEYSTONE",
"identifier": "0160922",
"state": "PA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0005170230001",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE SHIELD MEDICAL",
"identifier": "160922",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CAPITAL BLUE CROSS",
"identifier": "01176001",
"state": "PA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Pottsville, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.