Brianna Christine Freitag Vandervoort, DDS

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

062396-01 Issued in NY

Practice address

160 Broadway RM 1004
New York, NY 10038-4213

Phone

(127) 521-2287

NPI assigned

Mar 31, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1585612800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698883200000",
    "number": "1972131449",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "60 WATER ST APT 1111",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112011988",
            "telephone_number": "248-974-4503"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "160 BROADWAY RM 1004",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100384213",
            "telephone_number": "127-521-2287"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANDERVOORT",
        "first_name": "BRIANNA",
        "middle_name": "CHRISTINE FREITAG",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-03-31",
        "last_updated": "2023-11-02",
        "certification_date": "2023-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "NY",
            "license": "062396-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bryn Vandermark, AGNP-C
• Rachael Marie Vanderminden
• Jillian Nicole Vanderneut, LCSW
• Patricia Irene Vanderploeg, L.P.N.
• Caleb Vanderveen, M.D.
• Catherine Emily Vandeveld, LMSW
• Virginie Vandevoorde, LMT
• Tracy Helen Vandevorde, MS, OTR/L
• Katherine Vandiford, PT, DPT
• Leonardo Vando, MD

• Pediatric Dentistry in New York, NY
• Providers in New York, NY by specialty
• Pediatric Dentistry in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2023; 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.