Maria Terasa Van Dyke

Primary specialty

Supports Brokerage AgencyTaxonomy code 251X00000X

License

251X00000X Issued in OH

Practice address

2269 S Dixie Dr
Kettering, OH 45409-2018

Phone

(937) 723-0112

NPI assigned

Dec 18, 2023

Sex

Female

Sole proprietor

Yes

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

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": "1702857600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702857600000",
    "number": "1992573133",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1405 PHILLIPS AVE",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454102638",
            "telephone_number": "937-723-0112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2269 S DIXIE DR",
            "city": "KETTERING",
            "state": "OH",
            "postal_code": "454092018",
            "telephone_number": "937-723-0112"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAN DYKE",
        "first_name": "MARIA",
        "middle_name": "TERASA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-12-18",
        "last_updated": "2023-12-18",
        "certification_date": "2023-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "251X00000X",
            "taxonomy_group": "",
            "desc": "Supports Brokerage",
            "state": "OH",
            "license": "251X00000X",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Aaron Valenti
• Sarah Valentine, D.O.
• Marissa B Van Allen, CRNA
• Van Buren Dental
• Madison Anne Van Cucha, PHARMD
• Jenna Van Houten, BS, MS, LPCC
• Abigail Vandeberg
• Kailynn Renee Vanhoesen, MSW LSW
• Stephanie Susan Vanhouten, PHARMD
• Constance Marie Vann, APRN-CNP

• Supports Brokerage Agency in Kettering, OH
• Providers in Kettering, OH by specialty
• Supports Brokerage Agency in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 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.