DR. CHARLES DOUGLAS VANDYCK III (NPI# 1508915588) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1508915588 |
Entity Type | Individual |
Full Name | DR. CHARLES DOUGLAS VANDYCK III |
Credential | DDS, MSD |
Practice Address |
2601 16th Ave S Great Falls MT 59405-5202 |
Practice Telephone | 4067276232 |
Mailing Telephone | 4067276232 |
Enumeration Date | 2007-01-09 |
Last Update Date | 2007-07-08 |
Gender Code | M |
Is Sole Proprietor | Y |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 1223P0300X |
Dentist Specialization: Periodontics |
1369 | MT | Dental Providers |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1043262496 | Charles Tucker Vandyck | Optometrist | 9239 W Center Rd, Suite 103, Omaha, NE 68124-1900 | 2006-05-16 |
Street Address |
2601 16TH AVE S |
City | GREAT FALLS |
State | MT |
Zip Code | 59405-5202 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1902446180 | Reilly Kunz | Physical Therapist | 2621 15th Ave South, Great Falls, MT 59405 | 2020-01-15 |
1336617224 | Brandi Noel Sauer | Behavior Technician | 1601 2nd Ave North Suite 518, Great Falls, MT 59405 | 2018-11-08 |
1982103446 | Traci Raines Aprn Pllc | Nurse Practitioner | 120 Marillyn Dr, Great Falls, MT 59405 | 2018-02-09 |
1003332818 | Great Falls Health Supplies | Durable Medical Equipment & Medical Supplies | 1720 10th Ave., South, Suite 4-151, Great Falls, MT 59405 | 2017-08-15 |
1518489426 | Jessica Lynn Keller | Specialist/Technologist | 720 46th Street South, Great Falls, MT 59405 | 2017-07-12 |
1235678475 | Vanessa Claudia Hernandez | Occupational Therapist | 2621 15 Ave So, Great Falls, MT 59405 | 2017-02-21 |
1871039339 | Morgan Laux Olsen | Specialist/Technologist | 1301 20th St S, Great Falls, MT 59405 | 2017-01-09 |
1558807198 | Greg Robert Lipton | Occupational Therapist | 2621 15th Ave So, Great Falls, MT 59405 | 2017-01-06 |
1386180925 | Jessica Lee Krahn | Physical Therapist | 2621 15th Ave So., Great Falls, MT 59405 | 2017-01-06 |
1811430150 | Juli Brandvold | Massage Therapist | 2400 4th Ave S., Great Falls, MT 59405 | 2016-11-18 |
Find all providers in zip 59405 |
Taxonomy Code | 1223P0300X |
Grouping | Dental Providers |
Classification | Dentist |
Specialization | Periodontics |
That specialty of dentistry which encompasses the prevention, diagnosis and treatment of diseases of the supporting and surrounding tissues of the teeth or their substitutes and the maintenance of the health, function and esthetics of these structures and tissues. |
Notes: Source: Council on Dental Education and Licensure, American Dental Association |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1255599924 | Rocky Mountain Implants | Dentist | 1825 Us Highway 93 S, Suite A, Kalispell, MT 59901-5708 | 2008-05-29 |
1629297635 | John C Remien II | Dentist | 3817 Stephens Ave, Missoula, MT 59801-8505 | 2007-04-25 |
1457476194 | Stephen Phillip Walters | Dentist | 25 Discovery Dr, Butte, MT 59701 | 2007-03-20 |
1023181260 | Nanette B.i. Ault, D.d.s., P.C. | Dentist | 619 Sw Higgins Ave Ste G, Missoula, MT 59803-1430 | 2006-11-16 |
1861408940 | Scott Stuart Manhart | Dentist | 50 27th St W, Suite D, Billings, MT 59102-8601 | 2006-07-31 |
1588916811 | Walters and Erwin LLC | Dentist | 25 Discovery Dr, Butte, MT 59701-3124 | 2012-10-10 |
1679882203 | John M Remien | Dentist | 3817 Stephens Ave, Missoula, MT 59801-8505 | 2010-09-30 |
1750547436 | Nanette Ault | Dentist | 619 Sw Higgins Ave, Suite G, Missoula, MT 59803-1467 | 2008-08-01 |
1952424723 | Jaden Howard Erwin | Dentist | 25 Discovery Dr, Butte, MT 59701-3124 | 2007-04-09 |
1891830931 | Vermon Craig Barney | Dentist | 211 North Main, Boulder, MT 59632 | 2007-02-20 |
Find all providers with the same taxonomy |
City | GREAT FALLS |
Zip Code | 59405 |
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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.