Individual provider Active NPI

Federico Jose Perez Espinal, DMD

  • General Practice Dentistry
  • Fort Lauderdale, FL
National Provider Identifier
1619347747
Registry record updated Oct 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DN23301 Issued in FL
Practice address
301 SE 16TH St
Fort Lauderdale, FL 33316-2505
Phone
(954) 462-5252
Fax
(954) 462-5145
NPI assigned
Oct 1, 2015
Last updated
Oct 9, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 9, 2024

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 DN23301 FL Primary

Addresses

Primary practice location

301 SE 16TH St
Fort Lauderdale, FL 33316-2505

Mailing address

301 SE 16TH St
Fort Lauderdale, FL 33316-2505
Phone (954) 462-5252

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20170221001605 MA Order and Referring Only - DentistPractitioner - Dentist 4183908015

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DN23301FLMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Federico J Perez DMD Inc General Practice CurrentSince Oct 13, 2024 Accepting new patients
Randall L Davis DMD PC General Practice Past Accepting new patients

Locations

301 SE 16th St
Fort Lauderdale, FL 33316
Phone (954) 462-5252

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1443657600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728432000000",
    "number": "1619347747",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 SE 16TH ST",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333162505",
            "telephone_number": "954-462-5252"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 SE 16TH ST",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333162505",
            "telephone_number": "954-462-5252",
            "fax_number": "954-462-5145"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEREZ ESPINAL",
        "first_name": "FEDERICO",
        "middle_name": "JOSE",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-10-01",
        "last_updated": "2024-10-09",
        "certification_date": "2024-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN23301",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Lauderdale, FL

Sources for this page

Verify at the official NPI Registry.