MEDICARE: DAYRYS TEJEDA D.M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223P0221X	Pediatric Dentistry	052895	NY
2	1223P0221X	Pediatric Dentistry	DN17706	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1558524876
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DAYRYS TEJEDA D.M.D.

Provider Business Mailing Address
First Line	:	2711 SW 22ND AVE
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33133-3101
Country	:	US
Telephone Number	:	305-607-9297
Fax Number	:

Provider Business Practice Location Address
First Line	:	13757 SW 152ND ST
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33177-8125
Country	:	US
Telephone Number	:	305-250-5390
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/07/2008
Last Update Date	:	05/09/2024

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