NPIMap

Organization Active NPI

C.Leon Vasquez Dental Service PC

  • General Practice Dentistry
  • Woodside, NY
National Provider Identifier
1962674697
Registry record updated Apr 2, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
C.LEON VASQUEZ DENTAL SERVICE PC
Practice address
40-27 69TH St
Woodside, NY 11377-3836
Phone
(718) 507-9731
Fax
(718) 507-2700
NPI assigned
Apr 2, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 2, 2008

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

Authorized official

Name
Dr. Leon A Vasquez, DDS
Title
President
Phone
(718) 507-9731

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223G0001X Primary

Addresses

Primary practice location

40-27 69TH St
Woodside, NY 11377-3836

Mailing address

40-27 69TH St
Woodside, NY 11377-3836
Phone (718) 507-9731

Other identifiers 2

IdentifierTypeStateIssuer
01283150MedicaidNY
01283169MedicaidNY

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1207094400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1207094400000",
    "number": "1962674697",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40-27 69TH ST",
            "city": "WOODSIDE",
            "state": "NY",
            "postal_code": "113773836",
            "telephone_number": "718-507-9731",
            "fax_number": "718-507-2700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40-27 69TH ST",
            "city": "WOODSIDE",
            "state": "NY",
            "postal_code": "113773836",
            "telephone_number": "718-507-9731",
            "fax_number": "718-507-2700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "C.LEON VASQUEZ DENTAL SERVICE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-02",
        "last_updated": "2008-04-02",
        "status": "A",
        "authorized_official_last_name": "VASQUEZ",
        "authorized_official_first_name": "LEON",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "718-507-9731",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01283150",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01283169",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodside, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2008; 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.