Vincent T. Van, D.M.D.

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

DN19534 Issued in FL

Practice address

5316 Central Florida Pkwy
Orlando, FL 32821-8772

Phone

(407) 239-9557

NPI assigned

Sep 25, 2005

Last updated

Apr 24, 2013By 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 2

Addresses

Other identifiers 1

Other names 1

• Vincent T. Van Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Jacob D Groom DMD PLLC

  dba Hiddenbrook Dental

  • General Practice Dentistry
  • Vancouver, WA
  • NPI 1699560300
  NPD (past)
• Wendel Family Dental Centre PS

  • General Practice Dentistry
  • Vancouver, WA
  • NPI 1295844900
  NPD (past)

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

{
    "created_epoch": "1127606400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1366761600000",
    "number": "1942296942",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8749 THE ESPLANADE APT 27",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328367736",
            "telephone_number": "503-750-9718"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5316 CENTRAL FLORIDA PKWY",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328218772",
            "telephone_number": "407-239-9557"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAN",
        "first_name": "VINCENT",
        "middle_name": "T.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-25",
        "last_updated": "2013-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OR",
            "license": "D 8293",
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "FL",
            "license": "DN19534",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004545000",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "VINCENT",
            "last_name": "VAN",
            "middle_name": "T.",
            "credential": "D.M.D.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Nga Van
• Ngoc Anh Van, APRN
• Randy Van, RPH
• Thanh Cong Van, DPM
• Uyen Van
• Eduasvy Laurelle Vanbokklen, APRN, PMHNP-BC
• Barbara G. Vancamp, CTRS
• Tara Brook Vancil, OT
• Jerome Vandal, P.T.
• Eva Vandelist

• Pediatric Dentistry in Orlando, FL
• Providers in Orlando, FL by specialty
• Pediatric Dentistry in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2013; 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.