Provider Demographics
NPI:1366994592
Name:JANELY PINERO FREDRICK
Entity type:Organization
Organization Name:JANELY PINERO FREDRICK
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JANELY
Authorized Official - Middle Name:CARIDAD
Authorized Official - Last Name:PINERO FREDRICK
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:561-743-6700
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:561-762-0776
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:561-762-0776
Practice Address - Fax:561-743-9314
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:FREDRICK DENTAL, PA
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2016-11-04
Last Update Date:2016-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN14108122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty