Individual provider Active NPI

Randy Dennis Freedline, DDS.

  • General Practice Dentistry
  • Aventura, FL
National Provider Identifier
1447366604
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
9103 Issued in FL
Practice address
2627 N.E. 203 St.
Suite 212
Aventura, FL 33180
Phone
(305) 932-9202
Fax
(305) 932-8448
NPI assigned
Aug 21, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 9103 FL Primary

Addresses

Primary practice location

2627 N.E. 203 St.
Suite 212
Aventura, FL 33180

Mailing address

1948 N Oak Haven Cir
Miami, FL 33179-2844
Phone (305) 932-9202

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160623001719 FL Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 3375764384

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
9103FLMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Aventura Center for Dental Sleep Medicine, Inc PastSince Mar 13, 2013 Accepting new patients

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1156118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1447366604",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1948 N OAK HAVEN CIR",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331792844",
            "telephone_number": "305-932-9202",
            "fax_number": "305-932-8448"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2627 N.E. 203 ST.",
            "address_2": "SUITE 212",
            "city": "AVENTURA",
            "state": "FL",
            "postal_code": "33180",
            "telephone_number": "305-932-9202",
            "fax_number": "305-932-8448"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FREEDLINE",
        "first_name": "RANDY",
        "middle_name": "DENNIS",
        "name_prefix": "Dr.",
        "credential": "DDS.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "9103",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Aventura, FL

Sources for this page

Verify at the official NPI Registry.