Amalie Vance

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

34290 Issued in TX

Practice address

2411 Williams Dr Ste 111
Georgetown, TX 78628-3268

Phone

(877) 800-5722

NPI assigned

Aug 14, 2019

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

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in TX

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.

• Lone Star Circle of Care

  • Federally Qualified Health Center (FQHC)
  • Georgetown, TX
  • NPI 1891746970
  Medicare reassignment NPD
• Lone Star Circle of Care

  • Federally Qualified Health Center (FQHC)
  • Cedar Park, TX
  • NPI 1104476399
  NPD
• Lone Star Circle of Care

  • Federally Qualified Health Center (FQHC)
  • Austin, TX
  • NPI 1699289728
  NPD

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

{
    "created_epoch": "1565740800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709510400000",
    "number": "1972159010",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "205 E UNIVERSITY AVE STE 200",
            "city": "GEORGETOWN",
            "state": "TX",
            "postal_code": "786266821",
            "telephone_number": "512-994-1933"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2411 WILLIAMS DR STE 111",
            "city": "GEORGETOWN",
            "state": "TX",
            "postal_code": "786283268",
            "telephone_number": "877-800-5722"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "802 Avenue J",
            "address_purpose": "LOCATION",
            "city": "Marble Falls",
            "state": "TX",
            "postal_code": "786545125",
            "country_code": "US",
            "telephone_number": "877-800-5722",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VANCE",
        "first_name": "AMALIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-08-14",
        "last_updated": "2024-03-04",
        "certification_date": "2024-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TX",
            "license": "34290",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "34290",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "amalie.vance.p1@direct.lscctx.nextgenshare.com",
            "affiliation": "N",
            "address_1": "802 Avenue J",
            "city": "Marble Falls",
            "state": "TX",
            "country_code": "US",
            "postal_code": "786545125",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Jamie Valencia, NP
• John J Valentini Jr., MD
• Hope Van Der Heijden, R.D.
• Michaela Van Der Westhuizen, M.S., CCC-SLP
• Jenna Elizabeth Vanaskie, DPT
• Vicki Louise Vanpelt, DDS
• Taneeya Denae Vanterpool, FNP
• Enedelia Varela, LVN
• Erica Marina Vargas, PA-C
• Jayden Isaiah Vargas, CPHT

• General Practice Dentistry in Georgetown, TX
• Providers in Georgetown, TX by specialty
• General Practice Dentistry in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2024; 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.