Healthcare Provider Details

I. General information

NPI: 1528810116
Provider Name (Legal Business Name): VIRGINIA EUGENIA VANEGAS DMD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/05/2024
Last Update Date: 07/10/2025
Certification Date: 07/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

329 WESTGATE PLZ
FRANKLIN NC
28734-9012
US

IV. Provider business mailing address

3849 W TOTTORI DUNE DR
SOUTH JORDAN UT
84009-4717
US

V. Phone/Fax

Practice location:
  • Phone: 828-369-0618
  • Fax:
Mailing address:
  • Phone: 786-538-1126
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number13764
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: