Individual provider Active NPI

Veronika Virginia Vazquez, D.D.S.

  • Dentist
  • Reno, NV
National Provider Identifier
1790777951
Registry record updated Aug 11, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
53884 Issued in CA
Practice address
4360 Slide Mountain Cir
Reno, NV 89511-9530
Phone
(775) 453-0142
NPI assigned
Aug 15, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 11, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 53884 CA Primary
Oral and Maxillofacial Surgery (Dentist) 1223S0112X 7430 NV

Addresses

Primary practice location

4360 Slide Mountain Cir
Reno, NV 89511-9530

Mailing address

4360 Slide Mountain Cir
Reno, NV 89511-9530
Phone (775) 453-0142

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV, CA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20210909002937 NV Practitioner - DentistPractitioner - Oral Surgery 7214333673
I20221212001069 CA Practitioner - Dentist 7214333673

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
7430NVMDOral and Maxillofacial Surgery (Dentist)
53884CAMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1124064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628640000000",
    "number": "1790777951",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4360 SLIDE MOUNTAIN CIR",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895119530",
            "telephone_number": "775-453-0142"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4360 SLIDE MOUNTAIN CIR",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895119530",
            "telephone_number": "775-453-0142"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAZQUEZ",
        "first_name": "VERONIKA",
        "middle_name": "VIRGINIA",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-15",
        "last_updated": "2021-08-11",
        "certification_date": "2021-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "53884",
            "primary": true
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "NV",
            "license": "7430",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Reno, NV

Sources for this page

Verify at the official NPI Registry.