Wendy Vrijbloed, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

DN25439 Issued in FL

Practice address

1 11TH Ave Ste D3
Shalimar, FL 32579-1319

Phone

(850) 651-6700

NPI assigned

Aug 31, 2020

Last updated

Aug 31, 2020By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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

• Shalimar Family Dentistry

  • General Practice Dentistry
  • Shalimar, FL
  • NPI 1932111564
  NPD (past)

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

{
    "created_epoch": "1598832000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1598832000000",
    "number": "1679187439",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1510 CAMP CRAFT RD APT C",
            "city": "WEST LAKE HILLS",
            "state": "TX",
            "postal_code": "787466954",
            "telephone_number": "737-202-1879"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 11TH AVE STE D3",
            "city": "SHALIMAR",
            "state": "FL",
            "postal_code": "325791319",
            "telephone_number": "850-651-6700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VRIJBLOED",
        "first_name": "WENDY",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-08-31",
        "last_updated": "2020-08-31",
        "certification_date": "2020-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "DN25439",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Harold Earl Tullock, LMT
• Danielle Caryn Valcourt
• Norene M Vello, LPCC
• Jamie P Von Barnau Sythoff, BCABA
• Natasha Vosburgh
• Kathleen Harriet Wakefield, LMHC
• Holly A Ward, MD
• Morgan Wasik
• Amanda Weber, CCC SLP
• Janie M. Weeks-Long, CRNA

• Dentist in Shalimar, FL
• Providers in Shalimar, FL by specialty
• Dentist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 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.