Dustin Vermeulen OD & Associates PLLC

Primary specialty

OptometristTaxonomy code 152W00000X

License

1303 Issued in AZ

Legal business name

DUSTIN VERMEULEN OD & ASSOCIATES PLLC

Practice address

4824 E Baseline Rd
Ste 140
Mesa, AZ 85206-4676

Phone

(480) 969-4040

Fax

(480) 830-1402

NPI assigned

Jan 31, 2011

Organization subpart

No

Name

Robin Nice

Title

Billing Manager

Phone

(480) 969-4040

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jan 31, 2011.

{
    "created_epoch": "1296432000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1296432000000",
    "number": "1881990463",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4824 E BASELINE RD",
            "address_2": "STE 140",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852064676",
            "telephone_number": "480-969-4040",
            "fax_number": "480-830-1402"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4824 E BASELINE RD",
            "address_2": "STE 140",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852064676",
            "telephone_number": "480-969-4040",
            "fax_number": "480-830-1402"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DUSTIN VERMEULEN OD & ASSOCIATES PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-01-31",
        "last_updated": "2011-01-31",
        "status": "A",
        "authorized_official_last_name": "NICE",
        "authorized_official_first_name": "ROBIN",
        "authorized_official_title_or_position": "BILLING MANAGER",
        "authorized_official_telephone_number": "480-969-4040"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "AZ",
            "license": "1303",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Daniel J Durrant
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• All providers in Mesa, AZ
• Optometrist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2011; 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.