NPIMap

Organization Active NPI

Pezzella Family Dentistry LLC

  • Dental Clinic/Center
  • Saint Petersburg, FL
National Provider Identifier
1801330246
Registry record updated Dec 5, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
License
DN20846 Issued in FL
Legal business name
PEZZELLA FAMILY DENTISTRY LLC
Practice address
901 Tyrone Blvd N
Saint Petersburg, FL 33710-6332
Phone
(860) 966-3564
NPI assigned
Dec 5, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 5, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Salvatore Robert Pezzella, DMDNPI 1710388582
Title
Dentist/ Owner
Phone
(860) 966-3564

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X DN20846 FL Primary

Addresses

Primary practice location

901 Tyrone Blvd N
Saint Petersburg, FL 33710-6332

Mailing address

1637 Country Walk Dr
Fleming Isle, FL 32003-8614
Phone (860) 966-3564

National Provider Directory

National Provider Directory

Locations

901 Tyrone Blvd N
St Petersburg, FL 33710
Phone (727) 381-7888

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1480896000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1480896000000",
    "number": "1801330246",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1637 COUNTRY WALK DR",
            "city": "FLEMING ISLE",
            "state": "FL",
            "postal_code": "320038614",
            "telephone_number": "860-966-3564"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 TYRONE BLVD N",
            "city": "SAINT PETERSBURG",
            "state": "FL",
            "postal_code": "337106332",
            "telephone_number": "860-966-3564"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEZZELLA FAMILY DENTISTRY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-12-05",
        "last_updated": "2016-12-05",
        "status": "A",
        "authorized_official_last_name": "PEZZELLA",
        "authorized_official_first_name": "SALVATORE",
        "authorized_official_middle_name": "ROBERT",
        "authorized_official_title_or_position": "DENTIST/ OWNER",
        "authorized_official_telephone_number": "860-966-3564",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "FL",
            "license": "DN20846",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Petersburg, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2016; 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.