Individual provider Active NPI

Humberto Omar Vazquez Colon, D.M.D, B.S

  • General Practice Dentistry
  • Coto Laurel, PR
National Provider Identifier
1932443017
Registry record updated Nov 15, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
2912 Issued in PR
Practice address
7010 Paseo la Fortuna
Coto Laurel, PR 00780-2306
Phone
(787) 612-7597
NPI assigned
Nov 15, 2012
Last updated
Nov 15, 2012By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 15, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 2912 PR Primary

Addresses

Primary practice location

7010 Paseo la Fortuna
Coto Laurel, PR 00780-2306

Mailing address

7010 Paseo la Fortuna
Coto Laurel, PR 00780-2306
Phone (787) 612-7597

Other names 1

  • Dr. Humberto Vazquez Colon Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PR
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
I20161031000127 PR Order and Referring Only - DentistPractitioner - Dentist 2860770674

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Bachelor of Science

State licenses

LicenseStateTypeSpecialty
2912PRMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1352937600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1352937600000",
    "number": "1932443017",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7010 PASEO LA FORTUNA",
            "city": "COTO LAUREL",
            "state": "PR",
            "postal_code": "007802306",
            "telephone_number": "787-612-7597"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7010 PASEO LA FORTUNA",
            "city": "COTO LAUREL",
            "state": "PR",
            "postal_code": "007802306",
            "telephone_number": "787-612-7597"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAZQUEZ COLON",
        "first_name": "HUMBERTO",
        "middle_name": "OMAR",
        "credential": "D.M.D, B.S",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-11-15",
        "last_updated": "2012-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "PR",
            "license": "2912",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "HUMBERTO",
            "last_name": "VAZQUEZ COLON",
            "prefix": "DR.",
            "credential": "D.M.D, B.S",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Coto Laurel, PR

Sources for this page

Verify at the official NPI Registry.