Salvatore Robert Pezzella, D.M.D

Primary specialty

DentistTaxonomy code 122300000X

License

DN 20846 Issued in FL

Practice address

901 Tyrone Blvd N
St Petersburg, FL 33710-6332

Phone

(727) 381-7888

NPI assigned

Sep 11, 2014

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

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Pezzella Family Dentistry LLC

  • Dental Clinic/Center
  • Saint Petersburg, FL
  • NPI 1801330246
  NPD (past) Authorized official

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

{
    "created_epoch": "1410393600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1488499200000",
    "number": "1710388582",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "901 TYRONE BLVD N",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337106332",
            "telephone_number": "727-381-7888"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 TYRONE BLVD N",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337106332",
            "telephone_number": "727-381-7888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEZZELLA",
        "first_name": "SALVATORE",
        "middle_name": "ROBERT",
        "name_prefix": "Dr.",
        "credential": "D.M.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-09-11",
        "last_updated": "2017-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "DN 20846",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Presley Ann Pettit
• Trishae E Petty
• Dennis Joseph Pevarski, M.D.
• Katelyn Peworchik, ARNP
• Pezzella Family Dentistry LLC
• Julia A Pfaff, D.O.
• PFS Health LLC
• Christine Pham
• Danh Cong Pham, RPH
• Hung Pham, M.D.

• Dentist in St Petersburg, FL
• Providers in St Petersburg, FL by specialty
• Dentist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.