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SOUTHERN VERMONT ENDONTICS PC NPI 1558483321


NPI Information

NPI: 1558483321
Provider Name: SOUTHERN VERMONT ENDONTICS, PC
Classification: Dentist - 1223E0200X
Entity Type: Organization

Specialization: Endodontics

Address:
71 ALLEN ST
SUITE 204
RUTLAND, VT
ZIP 05701
Phone: (802) 773-7767
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SOUTHERN VERMONT ENDONTICS, PC is an endodontics dentist in Rutland, VT. The provider is 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. SOUTHERN VERMONT ENDONTICS, PC NPI is 1558483321. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

71 ALLEN ST
SUITE 204
RUTLAND, VT
ZIP 05701-570
Phone: (802) 773-7767
Fax: (802) 775-7667

The provider's authorized official is Cheryl Lang Ullman .
The authorized official title is President and has the following contact phone number (802) 773-7767.

The enumeration date for this NPI number is 4/4/2007 and was last updated on 8/22/2020.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
11223E0200XDentistEndodontics1124VERMONTYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
11009354MEDICAIDVERMONT

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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