Active NPI
Luis Vazquez
- Dental Laboratory Technician
- Colorado Springs, CO
National Provider Identifier
1841010071
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dental Laboratory Technician
- License
- 20181808745
- Practice address
- 2034 Devon St
Colorado Springs, CO 80909-1618 - Phone
- (719) 354-9403
- NPI assigned
- Oct 14, 2024
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dental Laboratory Technician | 126900000X | 20181808745 | CO | Primary |
Addresses
Primary practice location
2034 Devon St
Colorado Springs, CO 80909-1618
Mailing address
2034 Devon St
Colorado Springs, CO 80909-1618
Phone (719) 354-9403
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 20181808745 | CO | MD | Dental Laboratory Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1728864000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1728864000000",
"number": "1841010071",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2034 DEVON ST",
"city": "COLORADO SPRINGS",
"state": "CO",
"postal_code": "809091618",
"telephone_number": "719-354-9403"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2034 DEVON ST",
"city": "COLORADO SPRINGS",
"state": "CO",
"postal_code": "809091618",
"telephone_number": "719-354-9403"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VAZQUEZ",
"first_name": "LUIS",
"name_prefix": "Mr.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2024-10-14",
"last_updated": "2024-10-14",
"certification_date": "2024-10-13",
"status": "A"
},
"taxonomies": [
{
"code": "126900000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Dental Laboratory Technician",
"state": "CO",
"license": "20181808745",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Colorado Springs, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.