Provider Demographics
NPI:1942399894
Name:MAHON-VAZQUEZ, CLAUDIA A (DDS)
Entity type:Individual
Prefix:DR
First Name:CLAUDIA
Middle Name:A
Last Name:MAHON-VAZQUEZ
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:801 MOTOR PKWY
Mailing Address - Street 2:
Mailing Address - City:HAUPPAUGE
Mailing Address - State:NY
Mailing Address - Zip Code:11788-5256
Mailing Address - Country:US
Mailing Address - Phone:631-348-1501
Mailing Address - Fax:631-851-9334
Practice Address - Street 1:801 MOTOR PKWY
Practice Address - Street 2:
Practice Address - City:HAUPPAUGE
Practice Address - State:NY
Practice Address - Zip Code:11788-5256
Practice Address - Country:US
Practice Address - Phone:631-348-1501
Practice Address - Fax:631-851-9334
Is Sole Proprietor?:No
Enumeration Date:2006-10-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY042364-11223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice