Connor Van, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DN24147 Issued in FL

Practice address

7651 Ashley Park CT Ste 406
Orlando, FL 32835-6114

Phone

(617) 416-8016

NPI assigned

May 14, 2019

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Connor Van Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Ashley Park Dental Arts

  dba Ashley Park Dental

  • Dental Clinic/Center
  • Orlando, FL
  • NPI 1346882982
  NPD Authorized official

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

{
    "created_epoch": "1557792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1580947200000",
    "number": "1811553076",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7651 ASHLEY PARK CT STE 406",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328356114",
            "telephone_number": "407-794-1901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7651 ASHLEY PARK CT STE 406",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328356114",
            "telephone_number": "617-416-8016"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "338 N Magnolia Ave Ste C",
            "address_purpose": "LOCATION",
            "city": "Orlando",
            "state": "FL",
            "postal_code": "328011639",
            "country_code": "US",
            "telephone_number": "617-416-8016",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3185 Citrus Tower Blvd",
            "address_purpose": "LOCATION",
            "city": "Clermont",
            "state": "FL",
            "postal_code": "347116803",
            "country_code": "US",
            "telephone_number": "617-416-8016",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VAN",
        "first_name": "CONNOR",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-05-14",
        "last_updated": "2020-02-06",
        "certification_date": "2020-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN24147",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CONNOR",
            "last_name": "VAN",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Keith Camper Van Dyke, M.D.
• Travis Boyd Van Dyke, MD
• Lauren Van Exel
• Heather Jo Van Slyke, RN
• Anne K Van Wert, M.D.
• Jennie M Van, DMD
• Lydia T. Van, M.D.
• Nga Van
• Ngoc Anh Van, APRN
• Randy Van, RPH

• General Practice Dentistry in Orlando, FL
• Providers in Orlando, FL by specialty
• General Practice Dentistry in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 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.