Dan J Vandermeulen, DDS MS

Primary specialty

EndodonticsTaxonomy code 1223E0200X

License

10199 Issued in MI

Practice address

8191 Moorsbridge Road
Suite a
Portage, MI 49024

Phone

(269) 323-1022

Fax

(269) 323-0702

NPI assigned

Aug 18, 2006

Last updated

Jul 8, 2007By the provider in NPPES

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

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Dan J Vandermeulen DDS Ms & Ronald W Reoch DDS Ms PC

  • Endodontics
  • Portage, MI
  • NPI 1134233943
  NPD (past)

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

{
    "created_epoch": "1155859200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1659485464",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 FAIRVIEW",
            "city": "RICHLAND",
            "state": "MI",
            "postal_code": "49083",
            "telephone_number": "269-629-9465"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8191 MOORSBRIDGE ROAD",
            "address_2": "SUITE A",
            "city": "PORTAGE",
            "state": "MI",
            "postal_code": "49024",
            "telephone_number": "269-323-1022",
            "fax_number": "269-323-0702"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANDERMEULEN",
        "first_name": "DAN",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "DDS MS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-18",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "MI",
            "license": "10199",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF MI FOR MED CLAIMS",
            "identifier": "1953960010",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ray Christian Van de Walker, D.C.
• Anthony J Van Es, MD
• Lillian R Van Gelderen
• Nathan Douglas Van Hofwegen, D.D.S.
• Roger Allan Vander Beek, D.D.S.
• Mark Vandermyde
• Ciara Vanderploeg, PHD
• Kenneth M Vandervelde Jr., MD
• Susan Vandewalker, P.T.
• Ashley Vandis, A-GACNP

• Endodontics in Portage, MI
• Providers in Portage, MI by specialty
• Endodontics in Michigan

• 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.

Verify at the official NPI Registry.