Individual provider Active NPI

Omar Steven Vazquez, DDS

  • Dentist
  • Miami, FL
National Provider Identifier
1578078382
Registry record updated Dec 4, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DN23046 Issued in FL
Practice address
8215 SW 72ND Ave Apt 1217
Miami, FL 33143-7870
Phone
(786) 842-7761
NPI assigned
Dec 4, 2017
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 4, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DN23046 FL Primary

Addresses

Primary practice location

8215 SW 72ND Ave Apt 1217
Miami, FL 33143-7870

Mailing address

8215 SW 72ND Ave Apt 1217
Miami, FL 33143-7870
Phone (786) 842-7761

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200123000624 FL Order and Referring Only - DentistPractitioner - Dentist 9335574219

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Networks

  • Freedom Health HMO Network

NPI Registry JSON

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

{
    "created_epoch": "1512345600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1512345600000",
    "number": "1578078382",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8215 SW 72ND AVE APT 1217",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331437870",
            "telephone_number": "786-842-7761"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8215 SW 72ND AVE APT 1217",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331437870",
            "telephone_number": "786-842-7761"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAZQUEZ",
        "first_name": "OMAR",
        "middle_name": "STEVEN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-12-04",
        "last_updated": "2017-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "DN23046",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

Verify at the official NPI Registry.