Jan Cornelis Vanderest, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

2901014473 Issued in MI

Practice address

106 S Main St
Almont, MI 48003-1066

Phone

(810) 798-3941

Fax

(810) 798-3141

NPI assigned

Mar 19, 2007

Last updated

Nov 17, 2016By 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

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1174262400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1479340800000",
    "number": "1932223591",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 425",
            "address_2": "106 SOUTH MAIN ST",
            "city": "ALMONT",
            "state": "MI",
            "postal_code": "480030425",
            "telephone_number": "810-798-3941",
            "fax_number": "810-798-3141"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "106 S MAIN ST",
            "city": "ALMONT",
            "state": "MI",
            "postal_code": "480031066",
            "telephone_number": "810-798-3941",
            "fax_number": "810-798-3141"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANDEREST",
        "first_name": "JAN",
        "middle_name": "CORNELIS",
        "name_prefix": "Mr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-19",
        "last_updated": "2016-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "2901014473",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brooke Taylor Robinson, PT, DPT
• Lauren Sehdev, DMD
• Madison Leigh Simmons, MOT, OTR/L
• Skyline Camp and Conference Center (Skyline Camp and Retreat Center)
• Amie Vandenberg
• Mary Lynn Watts, MD
• Kathleen J Wells, DDS
• Matthew D Wolfe, DDS

• General Practice Dentistry in Almont, MI
• Providers in Almont, 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 Nov 17, 2016; 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.