Active NPI
Eduardo Guillermo Perez Jr., DDS
- Dentist
- Riverview, FL
National Provider Identifier
1821783796
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 30783
- Practice address
- 11104 Bloomingdale Ave
Riverview, FL 33578-3717 - Phone
- (813) 725-4347
- NPI assigned
- Apr 6, 2023
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 30783 | FL | Primary |
Addresses
Primary practice location
11104 Bloomingdale Ave
Riverview, FL 33578-3717
Mailing address
11104 Bloomingdale Ave
Riverview, FL 33578-3717
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 30783 | FL | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1680739200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1752624000000",
"number": "1821783796",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11104 BLOOMINGDALE AVE",
"city": "RIVERVIEW",
"state": "FL",
"postal_code": "335783717"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11104 BLOOMINGDALE AVE",
"city": "RIVERVIEW",
"state": "FL",
"postal_code": "335783717",
"telephone_number": "813-725-4347"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PEREZ",
"first_name": "EDUARDO",
"middle_name": "GUILLERMO",
"name_prefix": "Dr.",
"name_suffix": "Jr.",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2023-04-06",
"last_updated": "2025-07-16",
"certification_date": "2025-07-16",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "FL",
"license": "30783",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Riverview, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.