Individual provider Active NPI

Fred Stewart Feld, DMD

  • General Practice Dentistry
  • St Petersburg, FL
National Provider Identifier
1780689786
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
8156 Issued in FL
Practice address
715 49TH St N
St Petersburg, FL 33710-6610
Phone
(727) 321-0368
NPI assigned
Jun 16, 2005
Last updated
Jul 13, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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 8156 FL Primary

Addresses

Primary practice location

715 49TH St N
St Petersburg, FL 33710-6610

Mailing address

12331 Imperial Dr
Seminole, FL 33772-3924
Phone (727) 393-3394

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20160316001882 FL Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 5799081709

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
8156FLMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1118880000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1780689786",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12331 IMPERIAL DR",
            "city": "SEMINOLE",
            "state": "FL",
            "postal_code": "337723924",
            "telephone_number": "727-393-3394",
            "fax_number": "727-394-1514"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "715 49TH ST N",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337106610",
            "telephone_number": "727-321-0368"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FELD",
        "first_name": "FRED",
        "middle_name": "STEWART",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-16",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "8156",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St Petersburg, FL

Sources for this page

Verify at the official NPI Registry.