Individual provider Active NPI

Raquel B. Mazer-Gurmendi, DMD

  • General Practice Dentistry
  • Birmingham, AL
National Provider Identifier
1336206630
Registry record updated May 18, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
4806 Issued in AL
Practice address
1919 7TH Ave S
SDB-Box 82
Birmingham, AL 35294-0007
Phone
(205) 934-2340
Fax
(205) 934-7899
NPI assigned
Jan 3, 2007
Last updated
May 18, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 18, 2015

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 4806 AL Primary

Addresses

Primary practice location

1919 7TH Ave S
SDB-Box 82
Birmingham, AL 35294-0007

Mailing address

703 Colony Circle
Birmingham, AL 35209-5557
Phone (205) 934-1022

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

LicenseStateTypeSpecialty
4806ALMDOccupational Therapy Assistant

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1167782400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1431907200000",
    "number": "1336206630",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "703 COLONY CIRCLE",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352095557",
            "telephone_number": "205-934-1022",
            "fax_number": "205-975-2883"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1919 7TH AVE S",
            "address_2": "SDB-BOX 82",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352940007",
            "telephone_number": "205-934-2340",
            "fax_number": "205-934-7899"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAZER-GURMENDI",
        "first_name": "RAQUEL",
        "middle_name": "B.",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-03",
        "last_updated": "2015-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AL",
            "license": "4806",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Birmingham, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.