Individual provider Active NPI

Henry Mercer Vanderfin, DMD

  • Dentist
  • Huntsville, TX
National Provider Identifier
1912524737
Registry record updated Aug 25, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
37733 Issued in TX
Practice address
3011 Highway 30 W
Huntsville, TX 77340-3534
Phone
(936) 294-0400
NPI assigned
Jun 26, 2020
Last updated
Aug 25, 2021By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 25, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 37733 TX Primary

Addresses

Primary practice location

3011 Highway 30 W
Huntsville, TX 77340-3534

Mailing address

8204 Butler Ridge Dr
College Station, TX 77845-4150
Phone (805) 729-8218

Other names 1

  • Hank Mercer Vanderfin Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
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

Enrollment IDStateProvider typePAC IDDetails
I20201030002134 MD Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 6305256413

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
37733TXMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Huntsville Dental PLLC PastSince Aug 29, 2021 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1593129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629849600000",
    "number": "1912524737",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8204 BUTLER RIDGE DR",
            "city": "COLLEGE STATION",
            "state": "TX",
            "postal_code": "778454150",
            "telephone_number": "805-729-8218"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3011 HIGHWAY 30 W",
            "city": "HUNTSVILLE",
            "state": "TX",
            "postal_code": "773403534",
            "telephone_number": "936-294-0400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANDERFIN",
        "first_name": "HENRY",
        "middle_name": "MERCER",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-06-26",
        "last_updated": "2021-08-25",
        "certification_date": "2021-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TX",
            "license": "37733",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "HANK",
            "last_name": "VANDERFIN",
            "middle_name": "MERCER",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Huntsville, TX

Sources for this page

Verify at the official NPI Registry.