Active NPI
Robert Aurelio Vazquez, D.D.S.
- Periodontics
- Columbus, GA
National Provider Identifier
1992890107
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Periodontics
- License
- DN 012147
- Practice address
- 3908 Rosemont Dr
Columbus, GA 31904-5626 - Phone
- (706) 596-8850
- Fax
- (706) 596-8985
- NPI assigned
- Oct 4, 2006
- 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 |
|---|---|---|---|---|
| Periodontics | 1223P0300X | DN 012147 | GA | Primary |
Addresses
Primary practice location
3908 Rosemont Dr
Columbus, GA 31904-5626
Mailing address
3908 Rosemont Dr
Columbus, GA 31904-5626
Phone (706) 596-8850
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in GA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20150422002114 | GA | Order and Referring Only - Oral Surgery | 1355669375 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DN 012147 | GA | MD | Periodontist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159920000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1992890107",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3908 ROSEMONT DR",
"city": "COLUMBUS",
"state": "GA",
"postal_code": "319045626",
"telephone_number": "706-596-8850",
"fax_number": "706-596-8985"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3908 ROSEMONT DR",
"city": "COLUMBUS",
"state": "GA",
"postal_code": "319045626",
"telephone_number": "706-596-8850",
"fax_number": "706-596-8985"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VAZQUEZ",
"first_name": "ROBERT",
"middle_name": "AURELIO",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-10-04",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0300X",
"taxonomy_group": "",
"desc": "Dentist, Periodontics",
"state": "GA",
"license": "DN 012147",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Columbus, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.