Patrick Vanderhei, DDS, MSD

Primary specialty

ProsthodonticsTaxonomy code 1223P0700X

License

DN012702 Issued in GA

Practice address

3590 Braselton Hwy Ste 103
Dacula, GA 30019-1120

Phone

(678) 318-3353

Fax

(678) 318-3350

NPI assigned

Dec 20, 2006

Last updated

Jul 19, 2012By 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 2

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

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

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

• Van Derhei Implant and Prosthetics

  dba VIP Family Dentistry

  • Dental Clinic/Center
  • Dacula, GA
  • NPI 1710281795
  NPD (past) Authorized official
• Van Derhei Implant Prosthetics Dental LLC

  dba VIP Family Dentistry

  • General Practice Dentistry
  • Dacula, GA
  • NPI 1740251073
  Authorized official Same address or phone

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

{
    "created_epoch": "1166572800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1342656000000",
    "number": "1780748400",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3590 BRASELTON HWY STE 103",
            "city": "DACULA",
            "state": "GA",
            "postal_code": "300191120",
            "telephone_number": "678-318-3353",
            "fax_number": "678-318-3350"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3590 BRASELTON HWY STE 103",
            "city": "DACULA",
            "state": "GA",
            "postal_code": "300191120",
            "telephone_number": "678-318-3353",
            "fax_number": "678-318-3350"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANDERHEI",
        "first_name": "PATRICK",
        "credential": "DDS, MSD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-20",
        "last_updated": "2012-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "GA",
            "license": "DN012702",
            "primary": false
        },
        {
            "code": "1223P0700X",
            "taxonomy_group": "",
            "desc": "Dentist, Prosthodontics",
            "state": "GA",
            "license": "DN012702",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ultiwellness Solutions
• US Home Care Agency, Inc.
• Van Derhei Implant and Prosthetics (VIP Family Dentistry)
• Van Derhei Implant Prosthetics Dental LLC (VIP Family Dentistry)
• Wenona B Van Derhei, DDS
• Mykolas Varkalis, DMD
• Rolandine Vaughan, PAC
• Rabia Lynne Vaughns, PA-C
• Victory Eyecare LLC
• View Point Health

• Prosthodontics in Dacula, GA
• Providers in Dacula, GA by specialty
• Prosthodontics in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.