Fernando J Padron, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DN19637 Issued in FL

Practice address

1665 Eagle Harbor Pkwy
Fleming Island, FL 32003-4802

Phone

(904) 264-6700

Fax

(904) 264-6855

NPI assigned

Sep 26, 2012

Sex

Male

Sole proprietor

Yes

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

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.

Opted out of Medicare

Yes, effective Jan 20, 2016 through Jan 20, 2028

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Doctors Lake Family Dental

  • Dental Clinic/Center
  • Fleming Island, FL
  • NPI 1225876717
  NPD Authorized official

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

{
    "created_epoch": "1348617600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721260800000",
    "number": "1760733000",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1665 EAGLE HARBOR PKWY",
            "city": "FLEMING ISLAND",
            "state": "FL",
            "postal_code": "320034802",
            "telephone_number": "904-264-6700",
            "fax_number": "904-264-6855"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1665 EAGLE HARBOR PKWY",
            "city": "FLEMING ISLAND",
            "state": "FL",
            "postal_code": "320034802",
            "telephone_number": "904-264-6700",
            "fax_number": "904-264-6855"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PADRON",
        "first_name": "FERNANDO",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-09-26",
        "last_updated": "2024-07-18",
        "certification_date": "2024-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN19637",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• OB Hospitalist Group LLC
• Mellisa Ochoa
• Faith Isoken Omo-Erigbe
• Orthocare Express LLC
• Jennifer Renee Otterbach, FNP-BC
• Luis Eduardo Pardo Toro, MD
• Lauren Bennett Parrish, LMHC
• Anjli Patel
• Boski N Patel, FNP-BC
• Nepa M Patel

• General Practice Dentistry in Fleming Island, FL
• Providers in Fleming Island, FL by specialty
• General Practice Dentistry in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2024; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.