Eli Vang, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

6001027-15 Issued in WI

Practice address

2719 Calumet Ave
Manitowoc, WI 54220-5546

Phone

(920) 783-6633

NPI assigned

Jul 27, 2022

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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in WI

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

State licenses

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

{
    "created_epoch": "1658880000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658880000000",
    "number": "1932835485",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 959",
            "city": "SHEBOYGAN",
            "state": "WI",
            "postal_code": "530820959",
            "telephone_number": "920-783-6633"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2719 CALUMET AVE",
            "city": "MANITOWOC",
            "state": "WI",
            "postal_code": "542205546",
            "telephone_number": "920-783-6633"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANG",
        "first_name": "ELI",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-07-27",
        "last_updated": "2022-07-27",
        "certification_date": "2022-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WI",
            "license": "6001027-15",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WI STATE LICENSE",
            "identifier": "6001027-15",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mackenzie Vanden Heuvel, PT, DPT
• Angela Elaine Vandenberg, COTA
• Christine Vander Bloomen, LMT
• Angela R Vandewettering, NP
• Bao Vang
• Youa-PA Vang
• Amber Lynn Varela, LPN
• Ann Marie Verlare, LCSW
• Laurence J Verlinden, M.D.
• Emma S Vincent, M.S., CCC-SLP

• Dentist in Manitowoc, WI
• Providers in Manitowoc, WI by specialty
• Dentist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2022; 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.