Paul S Vanwalleghem, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D14525 Issued in MI

Practice address

50505 Schoenherr Rd
Ste 170
Shelby Township, MI 48315-3140

Phone

(586) 803-8300

NPI assigned

Apr 18, 2007

Last updated

Dec 8, 2011By 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 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

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

Specialty

Oral Surgery

Education

Other, 1986

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: pvanwalleghem1156320@direct.hfhs.org

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.

• Pointe Family Dentistry-Shelby PLLC

  • Dentist
  • Shelby TWP, MI
  • NPI 1083947162
  Medicare reassignment NPD Authorized official
• Pointe Family Dentistry

  • Dentist
  • Grosse Pointe Farms, MI
  • NPI 1528291382
  Authorized official Same address or phone
• Pointe Family Dentistry Washington

  dba Pointe Dental Group

  • General Practice Dentistry
  • Washington TWP, MI
  • NPI 1144172305
  NPD (past) Authorized official

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

{
    "created_epoch": "1176854400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1323302400000",
    "number": "1841416856",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50505 SCHOENHERR RD",
            "address_2": "STE 170",
            "city": "SHELBY TWP",
            "state": "MI",
            "postal_code": "483153140",
            "telephone_number": "313-886-9201",
            "fax_number": "313-881-5068"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50505 SCHOENHERR RD",
            "address_2": "STE 170",
            "city": "SHELBY TOWNSHIP",
            "state": "MI",
            "postal_code": "483153140",
            "telephone_number": "586-803-8300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANWALLEGHEM",
        "first_name": "PAUL",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-18",
        "last_updated": "2011-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "D14525",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Van de Vyver Dental, P.C. (Great Lakes Dentistry)
• Shawn Thomas Van de Vyver, DDS
• Kathleen P Vani, DDS PLLC
• Hailey Vansen, DC
• Zachary Vansen, D.C
• Michelle Vasille
• Jenna Vaught
• Vein Center at Allure Medical Spa, PLLC
• Vein Center at Allure Medical Spa, PLLC
• Lynda Kinsell Velanovich, R.D.

• General Practice Dentistry in Shelby Township, MI
• Providers in Shelby Township, MI by specialty
• General Practice Dentistry in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2011; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.