Catherine Wiechecki Vergara, D.D.S.

Primary specialty

DentistTaxonomy code 122300000X

License

DN15077 Issued in FL

Practice address

150 E Columbia LN
Cocoa Beach, FL 32931-4606

Phone

(321) 784-4794

Fax

(321) 783-0747

NPI assigned

Oct 25, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Catherine Vergara Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1161734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1386728558",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 E COLUMBIA LN",
            "city": "COCOA BEACH",
            "state": "FL",
            "postal_code": "329314606",
            "telephone_number": "321-784-4794",
            "fax_number": "321-783-0747"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 E COLUMBIA LN",
            "city": "COCOA BEACH",
            "state": "FL",
            "postal_code": "329314606",
            "telephone_number": "321-784-4794",
            "fax_number": "321-783-0747"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIECHECKI VERGARA",
        "first_name": "CATHERINE",
        "name_prefix": "Mrs.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-25",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "DN15077",
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TX",
            "license": "19449",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CATHERINE",
            "last_name": "VERGARA",
            "credential": "D.D.S.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

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• Dentist in Cocoa Beach, FL
• Providers in Cocoa Beach, FL by specialty
• Dentist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.

Verify at the official NPI Registry.