Fred Pedroletti, DMD

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

DN17712 Issued in FL

Practice address

7231 SW 63Rd Ave
South Miami, FL 33143-4809

Phone

(305) 667-1191

Fax

(305) 667-2712

NPI assigned

May 19, 2010

Last updated

Jun 8, 2020By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Opted out of Medicare

Yes, effective Apr 1, 2019 through Apr 1, 2027

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Oral Surgery & Implant Center

  • Oral and Maxillofacial Surgery Clinic/Center
  • South Miami, FL
  • NPI 1760964977
  NPD Authorized official
• Fred Pedroletti DMD PA

  • Dental Clinic/Center
  • South Miami, FL
  • NPI 1659770592
  Authorized official Same address or phone

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

{
    "created_epoch": "1274227200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1591574400000",
    "number": "1265751036",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7231 SW 63RD AVE",
            "city": "SOUTH MIAMI",
            "state": "FL",
            "postal_code": "331434809",
            "telephone_number": "305-667-1191",
            "fax_number": "305-667-2712"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7231 SW 63RD AVE",
            "city": "SOUTH MIAMI",
            "state": "FL",
            "postal_code": "331434809",
            "telephone_number": "305-667-1191",
            "fax_number": "305-667-2712"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEDROLETTI",
        "first_name": "FRED",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-05-19",
        "last_updated": "2020-06-08",
        "certification_date": "2020-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "FL",
            "license": "DN17712",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Paul W. Moo Young DDS PA
• Martha Tulia Pearson
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• Stephanie Pedrayes, DNP
• Denia Pedreira, M.D
• Sergio Luis Peguero Valdes, MD
• Oscar Jesus Peguero Jr., D.M.D.
• Carlos G. Pena, MD
• Adriana Alexandra Penate Armesto, MD
• Noris Peraita, ARNP, FNP B-C

• Oral and Maxillofacial Surgery (Dentist) in South Miami, FL
• Providers in South Miami, 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 Jun 8, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.