Robin Teresa Vaughan, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

2901014542 Issued in MI

Practice address

9041 N Rodgers CT SE
Caledonia, MI 49316-7660

Phone

(616) 891-8931

Fax

(616) 891-9803

NPI assigned

Aug 2, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Glen Valley Dentistry

  • General Practice Dentistry
  • Caledonia, MI
  • NPI 1538100482
  NPD (past) Authorized official

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

{
    "created_epoch": "1154476800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1689681322",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9091 ALANADA DR SE",
            "city": "CALEDONIA",
            "state": "MI",
            "postal_code": "493168453",
            "telephone_number": "616-891-8931",
            "fax_number": "616-891-9803"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9041 N RODGERS CT SE",
            "city": "CALEDONIA",
            "state": "MI",
            "postal_code": "493167660",
            "telephone_number": "616-891-8931",
            "fax_number": "616-891-9803"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAUGHAN",
        "first_name": "ROBIN",
        "middle_name": "TERESA",
        "name_prefix": "Mrs.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-02",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "2901014542",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI # FOR GLEN VALLEY D.",
            "identifier": "1538100482",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED CONCORDIA #",
            "identifier": "846910",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF MI ID #",
            "identifier": "D801041",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4836800",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Bradley Garrett Vanhoose, DDS, MS
• Mallory Vanregenmorter
• Nancy Jean Vantill, RPH
• Dennis Seth Vanwormer, D.O.
• Austin Vasquez
• Briana Virkstis
• Chelsey Lynne Walquist, MD
• Wesley Keith Washington, LPC
• Jolene Weesjes, DPT
• Julie Weisenberger

• General Practice Dentistry in Caledonia, MI
• Providers in Caledonia, MI by specialty
• General Practice Dentistry in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 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.