Provider Demographics
NPI:1821524869
Name:PINEROFREDRICK, JANELY CARIDAD (DDS)
Entity Type:Individual
Prefix:
First Name:JANELY
Middle Name:CARIDAD
Last Name:PINEROFREDRICK
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:JANELY
Other - Middle Name:CARIDAD
Other - Last Name:FREDRICK
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DDS
Mailing Address - Street 1:10156 INDIANTOWN RD
Mailing Address - Street 2:
Mailing Address - City:JUPITER
Mailing Address - State:FL
Mailing Address - Zip Code:33478-4707
Mailing Address - Country:US
Mailing Address - Phone:561-743-6700
Mailing Address - Fax:561-743-9314
Practice Address - Street 1:10156 INDIANTOWN RD
Practice Address - Street 2:
Practice Address - City:JUPITER
Practice Address - State:FL
Practice Address - Zip Code:33478-4707
Practice Address - Country:US
Practice Address - Phone:561-743-6700
Practice Address - Fax:561-743-9314
Is Sole Proprietor?:No
Enumeration Date:2017-05-11
Last Update Date:2017-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN141081223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice