Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Dr. Andrew Vansicklen, DDS

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1538457775

Dr. Andrew Vansicklen, DDS is a Student in an Organized Health Care Education/Training Program in San Luis Obispo, California. Licensed in California. Registered with an NPI since 2011.

Licensed in
CA
In the registry since
2011
Specialties on file
2
What do these letters mean?
DDS — Doctor of Dental Surgery
A dentist. DDS and DMD are the same qualification — universities choose which title to award.

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Practice location Address checks out

1042 Pacific St Ste B
San Luis Obispo, CA 93401
Phone: (805) 543-6963
Fax: (805) 543-8656
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

General Practice Dentistry (primary) Taxonomy 1223G0001X · Licence 61717 (CA)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X

Record details

NPI number1538457775
Entity typeIndividual (Type 1)
GenderMale
Credentials DDS
Sole proprietorNo
NPI enumeratedJuly 20, 2011
Last updated in NPPESMarch 17, 2016

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