Individual provider Active NPI

Gretel Valledor-Romero, D.M.D

  • General Practice Dentistry
  • Hialeah, FL
National Provider Identifier
1902030943
Registry record updated Aug 18, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DN17775 Issued in FL
Practice address
18652 NW 67TH Ave
Hialeah, FL 33015-2406
Phone
(305) 474-0400
Fax
(305) 474-0094
NPI assigned
May 5, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 18, 2015

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 DN17775 FL Primary

Addresses

Primary practice location

18652 NW 67TH Ave
Hialeah, FL 33015-2406

Mailing address

8998 NW 171 St
Hialeah, FL 33018
Phone (786) 409-7311

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
I20240103000713 FL Order and Referring Only - DentistPractitioner - Dentist 5698082428

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DN17775FLMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1241481600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1439856000000",
    "number": "1902030943",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8998 NW 171 ST",
            "city": "HIALEAH",
            "state": "FL",
            "postal_code": "33018",
            "telephone_number": "786-409-7311"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18652 NW 67TH AVE",
            "city": "HIALEAH",
            "state": "FL",
            "postal_code": "330152406",
            "telephone_number": "305-474-0400",
            "fax_number": "305-474-0094"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VALLEDOR-ROMERO",
        "first_name": "GRETEL",
        "credential": "D.M.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-05-05",
        "last_updated": "2015-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN17775",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hialeah, FL

Sources for this page

Verify at the official NPI Registry.