VAN DERHEI IMPLANT AND PROSTHETICS (NPI# 1710281795) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1710281795 |
| Entity Type | Organization |
| Organization Name | VAN DERHEI IMPLANT AND PROSTHETICS |
| Other Organization Name | VIP FAMILY DENTISTRY |
| Practice Address |
3590 Braselton Hwy Ste 103 Dacula GA 30019-1117 |
| Practice Telephone | 6783183353 |
| Practice Fax Number | 6783183350 |
| Mailing Telephone | 6783183353 |
| Mailing Fax Number | 6783183350 |
| Enumeration Date | 2011-01-05 |
| Last Update Date | 2012-07-19 |
| Authorized Official Name | DR. PATRICK VAN DERHEI (DENTIST) |
| Authorized Official Telephone | 6783183353 |
| Authorized Official Credential | DDS, MSD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261QD0000X |
Clinic/Center Specialization: Dental |
DN012702 | GA | Ambulatory Health Care Facilities |
| Y | 261QD0000X |
Clinic/Center Specialization: Dental |
DN011854 | GA | Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| VIP Family Dentistry | Doing Business As Name - Organization |
| Street Address |
3590 BRASELTON HWY STE 103 |
| City | DACULA |
| State | GA |
| Zip Code | 30019-1117 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457476608 | Samuel S Kwon Dmd PC | Dentist | 3590 Braselton Hwy, Suite 201, Dacula, GA 30019-1117 | 2007-03-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780228171 | Mackenson Lafortune | Physical Therapy Assistant | 1424 Filigree Pl, Dacula, GA 30019 | 2019-10-29 |
| 1780167452 | Adenike Alaga | Registered Nurse | 3196 Dolostone Way, Dacula, GA 30019 | 2018-09-10 |
| 1780160580 | Cielitha Ruffin | Nurse Practitioner | 1223 Bentley Estates Dr., Dacula, GA 30019 | 2018-07-15 |
| 1386135663 | Anke Mbapeh | Nurse Practitioner | 2100 Browning Bend Ct, Dacula, GA 30019 | 2018-05-23 |
| 1053820282 | Ethan Zachariah Merrow | Student in an Organized Health Care Education/Training Program | 1701 Mulberry Lake Drive, Dacula, GA 30019 | 2017-09-20 |
| 1043737547 | Dawn Hedley | Dietitian, Registered | 3567 Vern Way, Dacula, GA 30019 | 2017-08-25 |
| 1831545367 | Angela Owusu-edusei | Nurse Practitioner | 3226 Dolostone Way, Dacula, GA 30019 | 2016-05-13 |
| 1528458718 | Philomena Gyamfi | Registered Nurse | 1088 Milford Ln, Dacula, GA 30019 | 2015-01-27 |
| 1417375247 | Casey Goldman Sommerfeld | Pediatrics | 2240 Hamilton Creek Pkwy Ste 600, Dacula, GA 30019 | 2014-03-29 |
| 1417398215 | Samia Tahil | Home Health | 2821 Spence Ct, Dacula, GA 30019 | 2013-07-10 |
| Find all providers in zip 30019 | ||||
| Taxonomy Code | 261QD0000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Dental |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760745194 | Dental Smiles of America LLC | Clinic/Center | 1325 Auburn Rd, Dacula, GA 30019 | 2012-06-20 |
| 1932754223 | Ccsd-dacula, LLC | Clinic/Center | 420 Dacula Rd, Dacula, GA 30019-2128 | 2019-08-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922606490 | Smile Pleasant Hill LLC | Clinic/Center | 828 Pleasant Hill Rd Nw Ste 10, Lilburn, GA 30047-2757 | 2020-10-15 |
| 1982213583 | Munoz Dental Resources LLC | Clinic/Center | 4141 Steve Reynolds Blvd Ste 1, Norcross, GA 30093-3060 | 2020-07-29 |
| 1407474794 | Familia Dentistry of Georgia, LLC | Clinic/Center | 4574 Lawrenceville Hwy Nw Ste 120r, Lilburn, GA 30047-3605 | 2020-07-13 |
| 1336763648 | Bethlehem Orthodontics | Clinic/Center | 426 Exchange Blvd Ste 400, Bethlehem, GA 30620-1791 | 2020-06-02 |
| 1770106882 | Smiles By Dixon PC | Clinic/Center | 690 Lanier Park Dr, Gainesville, GA 30501-2061 | 2020-05-22 |
| 1811516479 | Mouthpeace Dental 4, LLC | Clinic/Center | 541 Forest Pkwy Ste 18, Forest Park, GA 30297-6110 | 2020-04-14 |
| 1427677541 | Mh Dental Group, LLC | Clinic/Center | 1305 Cedarcrest Rd Ste 115, Dallas, GA 30132-8201 | 2020-04-09 |
| 1104451160 | Sno Healthcare Group | Clinic/Center | 2424 Roswell Rd Ste 120, Marietta, GA 30062 | 2020-03-10 |
| 1952935710 | West Cobb Periodontics and Implant Dentistry LLC | Clinic/Center | 44 Old Hamilton Rd Nw Ste 200, Marietta, GA 30064-5901 | 2020-03-02 |
| 1659904241 | Dental Now Kids LLC | Clinic/Center | 4151 Steve Reynolds Blvd Ste 2, Norcross, GA 30093-3060 | 2020-02-21 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.