Provider Demographics
NPI:1558524876
Name:TEJEDA, DAYRYS (DMD)
Entity Type:Individual
Prefix:
First Name:DAYRYS
Middle Name:
Last Name:TEJEDA
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2501 BRICKELL AVE
Mailing Address - Street 2:APT #1207
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33129-2468
Mailing Address - Country:US
Mailing Address - Phone:973-432-4532
Mailing Address - Fax:
Practice Address - Street 1:4410 W 16TH AVE
Practice Address - Street 2:SUITE #52
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33012-7100
Practice Address - Country:US
Practice Address - Phone:305-825-9899
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-07-07
Last Update Date:2013-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN177061223P0221X
NY0528951223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry