Individual provider Active NPI

John Ronald Vaselaney, DDS

  • Dentist
  • Buffalo Grove, IL
National Provider Identifier
1730712811
Registry record updated Feb 18, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
019.019704 Issued in IL
Practice address
896 Plum Grove Cir
Buffalo Grove, IL 60089-1907
Phone
(847) 459-9262
NPI assigned
Feb 18, 2020
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 18, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 019.019704 IL Primary

Addresses

Primary practice location

896 Plum Grove Cir
Buffalo Grove, IL 60089-1907

Mailing address

896 Plum Grove Cir
Buffalo Grove, IL 60089-1907
Phone (847) 459-9262

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211207001095 WI Order and Referring Only - DentistPractitioner - Dentist 6204226228

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
019.019704ILMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1581984000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1581984000000",
    "number": "1730712811",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "896 PLUM GROVE CIR",
            "city": "BUFFALO GROVE",
            "state": "IL",
            "postal_code": "600891907",
            "telephone_number": "847-459-9262"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "896 PLUM GROVE CIR",
            "city": "BUFFALO GROVE",
            "state": "IL",
            "postal_code": "600891907",
            "telephone_number": "847-459-9262"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VASELANEY",
        "first_name": "JOHN",
        "middle_name": "RONALD",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-02-18",
        "last_updated": "2020-02-18",
        "certification_date": "2020-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": "019.019704",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Buffalo Grove, IL

Sources for this page

Verify at the official NPI Registry.