Provider Demographics
NPI:1457327231
Name:VAUGHN, DARREL GENE (DDS)
Entity Type:Individual
Prefix:DR
First Name:DARREL
Middle Name:GENE
Last Name:VAUGHN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2857 MEADOW WOOD DR E
Mailing Address - Street 2:
Mailing Address - City:CHESAPEAKE
Mailing Address - State:VA
Mailing Address - Zip Code:23321-4243
Mailing Address - Country:US
Mailing Address - Phone:757-966-1635
Mailing Address - Fax:
Practice Address - Street 1:NAVY MEDICINE READINESS AND TRAINING UNIT
Practice Address - Street 2:1711 DOOLITTLE AVE, NAS JRB FORT WORTH
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76127
Practice Address - Country:US
Practice Address - Phone:817-782-5905
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-02-23
Last Update Date:2023-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX18318122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist