Mark E Vanduker

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

D011921 Issued in AZ

Practice address

5717 E Thomas Rd Ste 110
Scottsdale, AZ 85251-7620

Phone

(480) 207-5070

NPI assigned

Mar 24, 2020

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

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 and National Provider Directory roles.

• Van Duker Pediatric PLLC

  • Pediatric Dentistry
  • Gilbert, AZ
  • NPI 1578331633
  NPD Authorized official

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

{
    "created_epoch": "1585008000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693267200000",
    "number": "1861029498",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "653 S BEEBE ST",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852960131",
            "telephone_number": "253-549-8789"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5717 E THOMAS RD STE 110",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852517620",
            "telephone_number": "480-207-5070"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1959 NE Pacific St # B-307",
            "address_purpose": "LOCATION",
            "city": "Seattle",
            "state": "WA",
            "postal_code": "981950001",
            "country_code": "US",
            "telephone_number": "206-616-6996",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "111 Michigan Ave NW",
            "address_purpose": "LOCATION",
            "city": "Washington",
            "state": "DC",
            "postal_code": "200102916",
            "country_code": "US",
            "telephone_number": "888-884-2327",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4528 Maple Ln SE Ste 201",
            "address_purpose": "LOCATION",
            "city": "Olympia",
            "state": "WA",
            "postal_code": "985018640",
            "country_code": "US",
            "telephone_number": "360-352-3515",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VANDUKER",
        "first_name": "MARK",
        "middle_name": "E",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-03-24",
        "last_updated": "2023-08-29",
        "certification_date": "2023-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "AZ",
            "license": "D011921",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Samantha M Vanderostyne, RNFA
• Juliana Hendrika Vanderpluym, M.D.
• Lauren Vanderwerf, MOTR/L
• Alexander John Vandetta, MD
• Hunter Bennett Vandolah, MD
• Vangard Medical Inc
• Kelly Leah Vanlandingham, MA CCC-SLP
• Jordyn Vannini
• Susan Louise Vannucci, D.O.
• Aimen Vanood, MD

• Pediatric Dentistry in Scottsdale, AZ
• Providers in Scottsdale, AZ by specialty
• Pediatric Dentistry in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2023; 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.