NPIMap

Organization Active NPI

Gregory P. Vannucci D.D.S.,P.C.

  • Oral and Maxillofacial Surgery (Dentist)
  • Ottumwa, IA
National Provider Identifier
1790969459
Registry record updated Dec 18, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
07963 Issued in IA
Legal business name
GREGORY P. VANNUCCI D.D.S.,P.C.
Practice address
1116 Pennsylvania Ave
Ottumwa, IA 52501-2109
Phone
(641) 682-2350
Fax
(641) 683-4616
NPI assigned
Dec 18, 2007
Last updated
Dec 18, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 18, 2007

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

Authorized official

Name
Dr. Gregory Paul Vannucci, D.D.S.NPI 1366435349
Title
President
Phone
(641) 682-2350

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist)Group: 193400000X SINGLE SPECIALTY GROUP 1223S0112X 07963 IA Primary

Addresses

Primary practice location

1116 Pennsylvania Ave
Ottumwa, IA 52501-2109

Mailing address

1116 Pennsylvania Ave
Ottumwa, IA 52501-2109
Phone (641) 682-2350

Other identifiers 1

IdentifierTypeStateIssuer
1182279MedicaidIA

National Provider Directory

National Provider Directory

Locations

1116 Pennsylvania Ave
Ottumwa, IA 52501
Phone (641) 682-2350

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1197936000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1197936000000",
    "number": "1790969459",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1116 PENNSYLVANIA AVE",
            "city": "OTTUMWA",
            "state": "IA",
            "postal_code": "525012109",
            "telephone_number": "641-682-2350",
            "fax_number": "641-683-4616"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1116 PENNSYLVANIA AVE",
            "city": "OTTUMWA",
            "state": "IA",
            "postal_code": "525012109",
            "telephone_number": "641-682-2350",
            "fax_number": "641-683-4616"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREGORY P. VANNUCCI D.D.S.,P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-18",
        "last_updated": "2007-12-18",
        "status": "A",
        "authorized_official_last_name": "VANNUCCI",
        "authorized_official_first_name": "GREGORY",
        "authorized_official_middle_name": "PAUL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "641-682-2350",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "IA",
            "license": "07963",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1182279",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ottumwa, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 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.