Vermont Dental Medicine PLLC

Primary specialty

DentistTaxonomy code 122300000X

License

016-0000615 Issued in VT

Legal business name

VERMONT DENTAL MEDICINE PLLC

Doing business as

Vermont Orofacial Pain Associates

Practice address

40 Timber LN
South Burlington, VT 05403-7204

Phone

(802) 862-7185

Fax

(802) 658-8036

NPI assigned

Jan 30, 2007

Last updated

May 28, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Reimy Evangelista de Leon, DDS, CAGS, MSNPI 1750867800

Title

Owner

Phone

(781) 385-0484

Specialties & licenses 2

Addresses

Other names 1

• Vermont Orofacial Pain Associates Doing business as

Medicare fee-for-service enrollment

Enrolled in VT

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Reimy Evangelista de Leon, DDS

  • Orofacial Pain Dentistry
  • South Burlington, VT
  • NPI 1750867800
  Medicare reassignment NPD Authorized official
• Linda R Bailey, MSN APRN- BC

  • Adult Health Nurse Practitioner
  • Plattsburgh, NY
  • NPI 1396866174
  NPD (past)

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

{
    "created_epoch": "1170115200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1716854400000",
    "number": "1932245362",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40A TIMBER LN",
            "city": "SOUTH BURLINGTON",
            "state": "VT",
            "postal_code": "054037204",
            "telephone_number": "802-862-7185",
            "fax_number": "802-658-8036"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40 TIMBER LN",
            "city": "SOUTH BURLINGTON",
            "state": "VT",
            "postal_code": "054037204",
            "telephone_number": "802-862-7185",
            "fax_number": "802-658-8036"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VERMONT DENTAL MEDICINE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-30",
        "last_updated": "2024-05-28",
        "certification_date": "2024-05-28",
        "status": "A",
        "authorized_official_last_name": "EVANGELISTA DE LEON",
        "authorized_official_first_name": "REIMY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "781-385-0484",
        "authorized_official_credential": "DDS, CAGS, MS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "VT",
            "license": "016-0000615",
            "primary": true
        },
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Vermont Orofacial Pain Associates",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Vermont Mindfulness and Psychotherapy L.L.C.

• Dentist in South Burlington, VT
• Providers in South Burlington, VT by specialty
• Dentist in Vermont

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.