Torey J Vande Walle, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

100151815 Issued in WI

Practice address

1800 State Road 16
La Crosse, WI 54601-3011

Phone

(608) 782-9667

NPI assigned

May 23, 2017

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 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

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Hixon Hills Dental, LLC

  • Dental Clinic/Center
  • La Crosse, WI
  • NPI 1659961670
  NPD Authorized official
• Kevin B. Cook, D.D.S., S.C.

  • General Practice Dentistry
  • La Crosse, WI
  • NPI 1396866026
  NPD (past)

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

{
    "created_epoch": "1495497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611360000000",
    "number": "1952839854",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1800 STATE ROAD 16",
            "city": "LA CROSSE",
            "state": "WI",
            "postal_code": "546013011",
            "telephone_number": "920-737-6701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1800 STATE ROAD 16",
            "city": "LA CROSSE",
            "state": "WI",
            "postal_code": "546013011",
            "telephone_number": "608-782-9667"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANDE WALLE",
        "first_name": "TOREY",
        "middle_name": "J",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-05-23",
        "last_updated": "2021-01-23",
        "certification_date": "2021-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WI",
            "license": "100151815",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Savanna Grace Van Vleck
• Tanya Van Vleet
• Leeann E Van Vreede, MS
• Andrea J Van Wyk, M.D.
• Sylvia V Vanatta, M.D.
• Joseph P Vandenberg, MD
• Samantha J Vander Bloomen, RD
• Theodore William Vanderhorst, D.O.
• Laura K Vanderlei, PA
• Barbara J Vandreese, APNP

• General Practice Dentistry in La Crosse, WI
• Providers in La Crosse, WI by specialty
• General Practice Dentistry in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2021; 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.