Individual provider Active NPI

Alexander Vanovost, D.D.S.

  • General Practice Dentistry
  • Fort Pierce, FL
National Provider Identifier
1639468341
Registry record updated Apr 4, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DN 11749 Issued in FL
Practice address
3209 Virginia Ave
Fort Pierce, FL 34981-5541
Phone
(772) 462-7524
NPI assigned
Apr 4, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 4, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DN 11749 FL Primary

Addresses

Primary practice location

3209 Virginia Ave
Fort Pierce, FL 34981-5541

Mailing address

3209 Virginia Ave
Fort Pierce, FL 34981-5541
Phone (772) 462-7524

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
DN 11749FLMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1301875200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1301875200000",
    "number": "1639468341",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3209 VIRGINIA AVE",
            "city": "FORT PIERCE",
            "state": "FL",
            "postal_code": "349815541",
            "telephone_number": "772-462-7524"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3209 VIRGINIA AVE",
            "city": "FORT PIERCE",
            "state": "FL",
            "postal_code": "349815541",
            "telephone_number": "772-462-7524"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANOVOST",
        "first_name": "ALEXANDER",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-04-04",
        "last_updated": "2011-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN 11749",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Pierce, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2011; 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.