Provider Demographics
NPI:1346703568
Name:ROMERO, JORGE (DMD)
Entity type:Individual
Prefix:
First Name:JORGE
Middle Name:
Last Name:ROMERO
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:JORGE
Other - Middle Name:ANTONIO
Other - Last Name:ROMERO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DMD
Mailing Address - Street 1:6631 W 14TH AVE
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33012-6238
Mailing Address - Country:US
Mailing Address - Phone:786-277-3365
Mailing Address - Fax:
Practice Address - Street 1:6075 POPLAR AVE STE 111
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38119-4740
Practice Address - Country:US
Practice Address - Phone:901-236-0648
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-14
Last Update Date:2025-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN127911223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery