DR. JACK L VANDYKE (NPI# 1417161555) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417161555 |
| Entity Type | Individual |
| Full Name | DR. JACK L VANDYKE |
| Credential | DMD |
| Practice Address |
640 Georig St Woodland WA 98674 |
| Mailing Address |
Po Box 1970 Woodland WA 98674 |
| Practice Telephone | 3602259494 |
| Practice Fax Number | 3602259495 |
| Mailing Telephone | 3602259494 |
| Mailing Fax Number | 3602259495 |
| Enumeration Date | 2007-05-09 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 122300000X | Dentist | 4991 | WA | Dental Providers |
| Street Address |
640 GEORIG ST |
| City | WOODLAND |
| State | WA |
| Zip Code | 98674 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790328409 | Susan E Van Skike | Social Worker | 38503 Nw Goose Hill Avenue, Woodland, WA 98674 | 2019-10-25 |
| 1336599323 | Erin Hutchinson | Counselor | 1251 Lewis River Road, Ste. A, Woodland, WA 98674 | 2016-06-21 |
| 1972977577 | Kelsey Ann Miller | Speech-Language Pathologist | 800 Second Street Wsd Special Service, Woodland, WA 98674 | 2015-11-19 |
| 1598194482 | Elizabeth Grendahl | Massage Therapist | 1227-h North Goerig, Woodland, WA 98674 | 2013-11-01 |
| 1417258674 | Safeway Pharmacy | Pharmacy | Safeway 1725 Pacific Avenue, Woodland, WA 98674 | 2010-11-04 |
| 1538370267 | Tiffany Marie Rose | Massage Therapist | 38803 Ne 2nd Ave, Lacenter, WA 98674 | 2007-05-24 |
| 1619934007 | Pearson Medical Clinic Pllc | Internal Medicine | 527 2nd Street, Woodland, WA 98674 | 2006-04-28 |
| 1083914733 | Wal-mart Stores Inc | Technician/Technologist | 1486 Dike Access Rd, Woodland, VA 98674 | 2010-10-28 |
| 1710018213 | Tammy Wallace | Specialist | 1227 Goerig Rd, Ste H, Woodland, WA 98674 | 2007-03-08 |
| 1275921090 | Mia Nicole Treasure | Specialist | 2418 Nw Hayes Rd, Woodland, WA 98674-2218 | 2014-12-31 |
| Find all providers in zip 98674 | ||||
| Taxonomy Code | 122300000X |
| Grouping | Dental Providers |
| Classification | Dentist |
| A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568947042 | Nikhil Sibal | Dentist | Woodland Family Dental, 58 W Court Street, Woodland, CA 95695 | 2018-10-01 |
| 1821479171 | Ritesh Diwan | Dentist | 1204 Cottonwood St Ste No2, Woodland, CA 95695-4362 | 2015-06-12 |
| 1689953663 | Sonny Sy Lim | Dentist | 1837 E Gibson Rd Ste D, Woodland, CA 95776-5161 | 2011-08-09 |
| 1376716845 | Steven William Thomson | Dentist | 825 East St #121, Woodland, CA 95776 | 2008-04-07 |
| 1639241516 | Jeffrey George Kohlhardt | Dentist | 1204 Cottonwood St, Woodland, CA 95695 | 2006-11-15 |
| 1659388833 | Jose M Aguilar | Dentist | 58 West Court, Woodland, CA 95695 | 2006-08-01 |
| 1033100524 | William L. Marble | Dentist | 74 W Lincoln Ave, Woodland, CA 95695-3868 | 2005-11-02 |
| 1548812845 | Alberto Vargas Martinez | Dentist | 2041 Bronze Star Dr Ste 100, Woodland, CA 95776-5428 | 2019-07-16 |
| 1720531973 | Rubina Khorana | Dentist | 2041 Bronze Star Dr, Ste 100, Woodland, CA 95776-5427 | 2016-07-24 |
| 1053716530 | David Sanchez | Dentist | 2041 Bronze Star Dr, Woodland, CA 95776-5427 | 2014-10-27 |
| Find all providers in WOODLAND | ||||
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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.