Heidi Mederos, DMD

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

DN22759 Issued in FL

Practice address

100 NW 82ND Ave Ste 101
Plantation, FL 33324-1834

Phone

(954) 358-4260

Fax

(954) 323-2600

NPI assigned

Jul 13, 2017

Sex

Female

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

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1499904000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629244800000",
    "number": "1669994372",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17773 SW 152ND PL",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331877762",
            "telephone_number": "305-910-8644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 NW 82ND AVE STE 101",
            "city": "PLANTATION",
            "state": "FL",
            "postal_code": "333241834",
            "telephone_number": "954-358-4260",
            "fax_number": "954-323-2600"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5531 N University Dr Ste 104",
            "address_purpose": "LOCATION",
            "city": "Coral Springs",
            "state": "FL",
            "postal_code": "330674649",
            "country_code": "US",
            "telephone_number": "954-358-4260",
            "fax_number": "954-323-2600",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MEDEROS",
        "first_name": "HEIDI",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-07-13",
        "last_updated": "2021-08-18",
        "certification_date": "2021-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "FL",
            "license": "DN22759",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Med-Care Home Health Services Inc
• Medaprime, Inc
• Sara Ann Medeiros, ARNP
• Rogelio Jose Medel, MD
• Mirta M. Mederos-Lezcano, MD
• Medfund LLC
• Medical Support Management
• Medikarma, Inc
• Yeney Medina Arencibia, BCBA, IBA, LBA (NC)
• Ashley Medina-Yntema, CCC-SLP

• Oral and Maxillofacial Surgery (Dentist) in Plantation, FL
• Providers in Plantation, 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 Aug 18, 2021; 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.