NPIMap

Organization Active NPI

David K. Vazquez D.D.S. PLC

Doing business as Motor Mouth Pediatric Dentistry

  • Pediatric Dentistry
  • Dearborn, MI
National Provider Identifier
1821614876
Registry record updated Jun 24, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
Legal business name
DAVID K. VAZQUEZ D.D.S. PLC
Doing business as
Motor Mouth Pediatric Dentistry
Practice address
1150 Mason St
Dearborn, MI 48124-2801
Phone
(313) 429-1005
Fax
(313) 429-1008
NPI assigned
Jun 24, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2020

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

Authorized official

Name
Dr. David K. Vazquez, D.D.SNPI 1487905998
Title
Owner
Phone
(313) 429-1005

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223P0221X Primary

Addresses

Primary practice location

1150 Mason St
Dearborn, MI 48124-2801

Mailing address

1150 Mason St
Dearborn, MI 48124-2801
Phone (313) 429-1005

Other practice location 1

3901 Beaubien St
Detroit, MI 48201-2119
Phone (313) 745-5477

Other identifiers 3

IdentifierTypeStateIssuer
1487905998MedicaidMI
1043749492MedicaidMI
1154701969MedicaidMI

Other names 1

  • Motor Mouth Pediatric Dentistry Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL Dearborn

National Provider Directory

National Provider Directory

Locations

1150 Mason St
Dearborn, MI 48124
Phone (313) 429-1005

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1592956800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1592956800000",
    "number": "1821614876",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1150 MASON ST",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481242801",
            "telephone_number": "313-429-1005",
            "fax_number": "313-429-1008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1150 MASON ST",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481242801",
            "telephone_number": "313-429-1005",
            "fax_number": "313-429-1008"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3901 Beaubien St",
            "address_purpose": "LOCATION",
            "city": "Detroit",
            "state": "MI",
            "postal_code": "482012119",
            "country_code": "US",
            "telephone_number": "313-745-5477",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "DAVID K. VAZQUEZ D.D.S. PLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-06-24",
        "last_updated": "2020-06-24",
        "certification_date": "2020-06-24",
        "status": "A",
        "authorized_official_last_name": "VAZQUEZ",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "K.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "313-429-1005",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1487905998",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1043749492",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1154701969",
            "state": "MI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Dearborn",
            "affiliation": "N",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Detroit",
            "address_1": "3901 Beaubien St",
            "city": "Detroit",
            "state": "MI",
            "country_code": "US",
            "postal_code": "482012196",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Motor Mouth Pediatric Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Dearborn, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2020; 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.