Alexander John Vandetta, MD

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

Practice address

7400 E Osborn Rd
Scottsdale, AZ 85251-6432

Phone

(480) 882-4000

NPI assigned

Jul 20, 2023

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

Other names 1

• Dr. Alec Van Detta Other name

Medicare fee-for-service enrollment

Enrolled in AZ

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1689811200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749081600000",
    "number": "1831879279",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7400 E OSBORN RD",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852516432",
            "telephone_number": "480-882-4000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7400 E OSBORN RD",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852516432",
            "telephone_number": "480-882-4000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "27 S Mario Capecchi Dr",
            "address_purpose": "LOCATION",
            "city": "Salt Lake City",
            "state": "UT",
            "postal_code": "841125888",
            "country_code": "US",
            "telephone_number": "801-860-3771",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VANDETTA",
        "first_name": "ALEXANDER",
        "middle_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-07-20",
        "last_updated": "2025-06-05",
        "certification_date": "2025-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "UT",
            "license": null,
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "AZ",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ALEC",
            "last_name": "VAN DETTA",
            "prefix": "DR.",
            "credential": "MD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Beth Driesja Vander Schaaf, DDS
• Elsa Vandermus
• Samantha M Vanderostyne, RNFA
• Juliana Hendrika Vanderpluym, M.D.
• Lauren Vanderwerf, MOTR/L
• Hunter Bennett Vandolah, MD
• Mark E Vanduker
• Vangard Medical Inc
• Kelly Leah Vanlandingham, MA CCC-SLP
• Jordyn Vannini

• Student in an Organized Health Care Education/Training Program in Scottsdale, AZ
• Providers in Scottsdale, AZ by specialty
• Student in an Organized Health Care Education/Training Program in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2025; 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.