Deborah Pedoeem

Primary specialty

DentistTaxonomy code 122300000X

License

22DI02841900 Issued in NJ

Practice address

3426 John F Kennedy Blvd
Jersey City, NJ 07307-4106

Phone

(201) 217-9670

NPI assigned

Apr 21, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1618963200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661904000000",
    "number": "1851973796",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3426 JOHN F KENNEDY BLVD",
            "city": "JERSEY CITY",
            "state": "NJ",
            "postal_code": "073074106",
            "telephone_number": "201-217-9670"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3426 JOHN F KENNEDY BLVD",
            "city": "JERSEY CITY",
            "state": "NJ",
            "postal_code": "073074106",
            "telephone_number": "201-217-9670"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "860 Grove St",
            "address_purpose": "LOCATION",
            "city": "Irvington",
            "state": "NJ",
            "postal_code": "071113601",
            "country_code": "US",
            "telephone_number": "973-373-0499",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PEDOEEM",
        "first_name": "DEBORAH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-04-21",
        "last_updated": "2022-08-31",
        "certification_date": "2022-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "062699",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NJ",
            "license": "22DI02841900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Pediatric Clinic of North Jersey
• Pediatric Home PT LLC
• Pediatric Practice
• Pediatric Therapy Resources, LLC
• Pediatrics A1, LLC
• Victoria S Pedoeem, D.D.S.
• Marquise Peel, ATC
• Pei Lin, MD
• Alicia Pelingon
• Ralph Pellecchia, M.D.

• Dentist in Jersey City, NJ
• Providers in Jersey City, NJ by specialty
• Dentist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2022; 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.