Sandra Maria Perozo Vazquez

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

088 Issued in OK

Practice address

9607 E 95TH CT S
Tulsa, OK 74133-5839

Phone

(918) 288-0818

NPI assigned

Jun 14, 2023

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Jun 24, 2025 through Jun 24, 2027

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Tulsa Dental Implants and Periodontics

  • Dental Clinic/Center
  • Tulsa, OK
  • NPI 1548501133
  NPD

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

{
    "created_epoch": "1686700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686700800000",
    "number": "1386328862",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6689 E 129TH ST S",
            "city": "BIXBY",
            "state": "OK",
            "postal_code": "740082503",
            "telephone_number": "832-991-2555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9607 E 95TH CT S",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741335839",
            "telephone_number": "918-288-0818"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEROZO VAZQUEZ",
        "first_name": "SANDRA",
        "middle_name": "MARIA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-06-14",
        "last_updated": "2023-06-14",
        "certification_date": "2023-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "OK",
            "license": "088",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Virginia Ryan Perkins, LPC
• Clinton Permenter, M.D.
• Anglic Marie Permetter
• Cameron Ikaika Pernich, DO
• John Lee Perona Jr., MD
• Autumn Perry, PTA
• James H Perry Jr.
• Jamie Lynne Perry, LMSW
• Jeffrey Alan Perry, MD
• Jeremy David Perry, CRNA

• Periodontics in Tulsa, OK
• Providers in Tulsa, OK by specialty
• Periodontics in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.