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Deactivated NPI 1174512388 Deactivated / Inactive NPI Male Practitioner

Dr. Gerald W Vidan , DDS

Dentist - General Practice • Eudora, KS

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Dr. Gerald Vidan has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date October 20, 2005
NPI Deactivation Date June 14, 2021
Total Practice Duration ~16 Years of Practice (2005 – 2021)

Professional Overview & Biography Verified Profile Summary

Dr. Gerald Vidan, DDS was a registered Dentist - General Practice practicing in Eudora, KS. Throughout an active medical career spanning 16 years, Dr. Vidan provided care at the practice location at 105 W 10TH ST until profile deactivation on 2021-06-14.

Practice Location & Contact Primary Location

Practice Address

105 W 10th St

Eudora, KS 660259593

Telephone 7855422993

Specialty Benchmarks & Practice Insights

Comparative analytics for Dentist - General Practice in Eudora, KS

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 17.8 Yrs
Regional Practice Density
1 Specialists

Practicing in Eudora, KS (1140 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Dentist - General Practice Primary Specialty

NUCC Taxonomy Code: 1223G0001X

State License KS 7077

A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events
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NPI Profile Deactivated June 14, 2021

Record deactivated on June 14, 2021

NPI Profile Active July 08, 2007

NPI status registered as active in NPPES database

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Updated Practice Location July 08, 2007

Registered at 105 W 10TH ST, EUDORA, KS 660259593 (Tel: 7855422993)

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Updated Business Mailing Address July 08, 2007

Registered at 538 CHURCH ST, EUDORA, KS 660259516 (Tel: 7855422143)

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Provider Name / Credentials Updated July 08, 2007

Recorded as GERALD VIDAN, D.D.S.

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Medical Taxonomy / Specialty Registered (Primary Specialty) July 08, 2007

Dentist (License #7077 in KS)

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Initial NPI Registration & Enumeration October 20, 2005

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1174512388
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: October 20, 2005
Last Update: July 08, 2007
Deactivation Date: June 14, 2021

Mailing Address

538 Church St

Eudora, KS 660259516

Phone: 7855422143

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.