Active NPI
Maria A Vazquez, D.D.S
- Dentist
- Indio, CA
National Provider Identifier
1043404411
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 4427301
- Practice address
- 45975 Fargo St Ste 1
Indio, CA 92201-4587 - Phone
- (760) 775-3368
- NPI assigned
- Aug 29, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 4427301 | CA | Primary |
Addresses
Primary practice location
45975 Fargo St Ste 1
Indio, CA 92201-4587
Mailing address
45975 Fargo St Ste 1
Indio, CA 92201-4587
Phone (760) 775-3368
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| B4427301 | Other | CA | DENTICAL |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4427301 | CA | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1188345600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1188345600000",
"number": "1043404411",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "45975 FARGO ST STE 1",
"city": "INDIO",
"state": "CA",
"postal_code": "922014587",
"telephone_number": "760-775-3368"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "45975 FARGO ST STE 1",
"city": "INDIO",
"state": "CA",
"postal_code": "922014587",
"telephone_number": "760-775-3368"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VAZQUEZ",
"first_name": "MARIA",
"middle_name": "A",
"name_prefix": "Mrs.",
"credential": "D.D.S",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-08-29",
"last_updated": "2007-08-29",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CA",
"license": "4427301",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DENTICAL",
"identifier": "B4427301",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Indio, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.