Active NPI
Eric Allen Vanvenrooy, D.D.S.
- General Practice Dentistry
- Cecilton, MD
National Provider Identifier
1972717833
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 11840
- Practice address
- 121 W Main St
Cecilton, MD 21913-1142 - Phone
- (410) 275-1462
- Fax
- (410) 275-1463
- NPI assigned
- May 10, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 11840 | MD | Primary |
Addresses
Primary practice location
121 W Main St
Cecilton, MD 21913-1142
Mailing address
PO Box 686
Cecilton, MD 21913-0686
Phone (410) 275-1462
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11840 | MD | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1178755200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1670371200000",
"number": "1972717833",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 686",
"city": "CECILTON",
"state": "MD",
"postal_code": "219130686",
"telephone_number": "410-275-1462",
"fax_number": "410-275-1463"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "121 W MAIN ST",
"city": "CECILTON",
"state": "MD",
"postal_code": "219131142",
"telephone_number": "410-275-1462",
"fax_number": "410-275-1463"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VANVENROOY",
"first_name": "ERIC",
"middle_name": "ALLEN",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-05-10",
"last_updated": "2022-12-07",
"certification_date": "2022-12-07",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "MD",
"license": "11840",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Cecilton, MD
- Davis Taylor Short, LCSW-C
- Upper Bay Counseling & Support Services, Inc
- Upper Bay Counseling & Support Services, Inc
- Upper Bay Counseling & Support Services, Inc
- Upper Bay Counseling & Support Services, Inc
- Wallace Bruce Obenshain Cecilton Family Practice
- West Cecil Health Center Inc.
- West Cecil Health Center Inc.
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.