MEDICARE: DR. NICHOLAS CADE VASQUEZ DMD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	390200000X	Student in an Organized Health Care Education/Training Program
2	122300000X	Dentist	D.007533-C1	AL

General Provider Information

NPI Number	:	1710670823
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. NICHOLAS CADE VASQUEZ DMD

Provider Business Mailing Address
First Line	:	940 VETERANS MEMORIAL PKWY
Second Line	:
City	:	TUSCALOOSA
State	:	AL
Zip	:	35404-5810
Country	:	US
Telephone Number	:	205-535-3205
Fax Number	:

Provider Business Practice Location Address
First Line	:	940 VETERANS MEMORIAL PKWY
Second Line	:
City	:	TUSCALOOSA
State	:	AL
Zip	:	35404-5810
Country	:	US
Telephone Number	:	205-535-3205
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/02/2023
Last Update Date	:	07/18/2025

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