NPIMap

Organization Active NPI

Jefferson M. Pecora DMD PA

  • Dental Clinic/Center
  • Palm Bay, FL
National Provider Identifier
1598286387
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
License
DN13729 Issued in FL
Legal business name
JEFFERSON M. PECORA DMD PA
Practice address
2105 Palm Bay Rd NE Ste 4-5
Palm Bay, FL 32905-2937
Phone
(321) 725-7644
NPI assigned
Jun 30, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Jefferson M Pecora, DMDNPI 1831396282
Title
President
Phone
(321) 725-7644

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X DN13729 FL Primary

Addresses

Primary practice location

2105 Palm Bay Rd NE Ste 4-5
Palm Bay, FL 32905-2937

Mailing address

2105 Palm Bay Rd NE Ste 4-5
Palm Bay, FL 32905-2937
Phone (321) 725-7644

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1498780800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1598286387",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2105 PALM BAY RD NE STE 4-5",
            "city": "PALM BAY",
            "state": "FL",
            "postal_code": "329052937",
            "telephone_number": "321-725-7644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2105 PALM BAY RD NE STE 4-5",
            "city": "PALM BAY",
            "state": "FL",
            "postal_code": "329052937",
            "telephone_number": "321-725-7644"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JEFFERSON M. PECORA DMD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-06-30",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "PECORA",
        "authorized_official_first_name": "JEFFERSON",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "321-725-7644",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "FL",
            "license": "DN13729",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palm Bay, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.