DR. RAYMOND MCREADY TRAVIS VANDERWERF (NPI# 1013126101) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1013126101 |
| Entity Type | Individual |
| Full Name | DR. RAYMOND MCREADY TRAVIS VANDERWERF |
| Credential | DDS, CAGS |
| Practice Address |
1630 S Stapley Dr #208 Mesa AZ 85204-6657 |
| Practice Telephone | 4807752656 |
| Mailing Telephone | 4807752656 |
| Enumeration Date | 2007-05-22 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223E0200X |
Dentist Specialization: Endodontics |
2117 | AZ | Dental Providers |
| Street Address |
1630 S STAPLEY DR #208 |
| City | MESA |
| State | AZ |
| Zip Code | 85204-6657 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194374819 | Luminations Healing Center, LLC | Social Worker | 1237 S. Val Vista Dr. #221, Mesa, AZ 85204 | 2019-09-05 |
| 1881160356 | Wanjiru Landers | Student in an Organized Health Care Education/Training Program | 550 S Linda Circle, Mesa, AZ 85204 | 2018-10-22 |
| 1649754235 | Adam Desnous | Specialist/Technologist | 751 S Daley, Mesa, AZ 85204 | 2018-09-19 |
| 1982128187 | Michael Anthony Jones | Counselor | 1107 North Gilbert Rd, Mesa, AZ 85204 | 2017-07-29 |
| 1295287225 | Scottsdale Healthcare Corp | Family Medicine | 2530 W. Southern Ave, Mesa, AZ 85204 | 2016-10-25 |
| 1427504158 | Richard White | Physician Assistant | 2345 E Southern Ave # 101, Mesa, AZ 85204 | 2016-09-01 |
| 1548716780 | Pain Stop Accident Injury LLC | Chiropractor | 425 E 11th Ave, Mesa, AZ 85204 | 2016-08-28 |
| 1154704252 | Glenn Taylor Lesueur | Dentist | 1056 S. Val Vista Dr., Suite 1, Mesa, AZ 85204 | 2015-07-07 |
| 1073932513 | Naomi Devine | Nurse Practitioner | 1840 South Stapley Drive, Suite 101, Mesa, AZ 85204 | 2014-04-14 |
| 1609292531 | John Kamau | Counselor | 1060 S Lobin Ln, Mesa, AZ 85204 | 2014-03-17 |
| Find all providers in zip 85204 | ||||
| Taxonomy Code | 1223E0200X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Endodontics |
| The branch of dentistry that is concerned with the morphology, physiology and pathology of the human dental pulp and periradicular tissues. Its study and practice encompass the basic and clinical sciences including biology of the normal pulp, the etiology, diagnosis, prevention and treatment of diseases and injuries of the pulp and associated periradicular conditions. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366962995 | Mesa Endodontics Pllc | Dentist | 2855 E Brown Rd Ste 15, Mesa, AZ 85213-4216 | 2017-06-25 |
| 1255762175 | Stephen L. Walker Dds Pllc | Dentist | 2220 W Southern Ave Ste 102, Mesa, AZ 85202-4706 | 2013-12-03 |
| 1548534035 | Isaac Edmundson Pratt | Dentist | 1712 S Country Club Dr Ste 104, Mesa, AZ 85210-6046 | 2012-02-29 |
| 1750655627 | Jonathan Bruce Barnes | Dentist | 1630 S Stapley Dr Ste 208, Mesa, AZ 85204-6659 | 2012-02-23 |
| 1770898488 | David Glen Mortenson | Dentist | 2208 S Barrington, Mesa, AZ 85209-5328 | 2010-08-18 |
| 1861544256 | Superstition Springs Endodontics, LLP | Dentist | 6755 E Superstition Springs Blvd Ste 101, Mesa, AZ 85206-4375 | 2007-01-17 |
| 1255493151 | James D. Hamberlin | Dentist | 1056 S Val Vista Dr Ste 3, Mesa, AZ 85204-5671 | 2006-12-15 |
| 1720166499 | Stephen L. Walker | Dentist | 2220 W Southern Ave, 102, Mesa, AZ 85202-4772 | 2006-11-01 |
| 1225115942 | Brian Allen Christopherson | Dentist | 1635 N Greenfield Rd Ste 119, Mesa, AZ 85205-4010 | 2006-11-01 |
| 1083668230 | Endodontic Specialists Ltd | Dentist | 2220 W Southern Avenue, Suite #102, Mesa, AZ 85202-4704 | 2006-05-20 |
| Find all providers in MESA | ||||
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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.