Roy Dennis Bedrock, MS DMD MD

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

28619 Issued in FL

Practice address

1008 Woodlawn St
Clearwater, FL 33756-2157

Phone

(727) 216-6155

Fax

(727) 216-6155

NPI assigned

Jun 30, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine, Master of Science

State licenses

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

{
    "created_epoch": "1151625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698883200000",
    "number": "1073541629",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1008 WOODLAWN ST",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337562157",
            "telephone_number": "727-216-6155",
            "fax_number": "727-216-6155"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1008 WOODLAWN ST",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337562157",
            "telephone_number": "727-216-6155",
            "fax_number": "727-216-6155"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEDROCK",
        "first_name": "ROY",
        "middle_name": "DENNIS",
        "name_prefix": "Dr.",
        "credential": "MS DMD MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-30",
        "last_updated": "2023-11-02",
        "certification_date": "2023-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "FL",
            "license": "28619",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carol Becker, MA, CCC-SLP
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• Oral and Maxillofacial Surgery (Dentist) in Clearwater, FL
• Providers in Clearwater, FL by specialty
• Oral and Maxillofacial Surgery (Dentist) in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2023; 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.