Provider Demographics
NPI:1053290403
Name:ROSELL PADRON, YESENIA (DMD)
Entity type:Individual
Prefix:
First Name:YESENIA
Middle Name:
Last Name:ROSELL PADRON
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 1:3600 NW 99TH ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33147-1943
Mailing Address - Country:US
Mailing Address - Phone:786-695-1938
Mailing Address - Fax:
Practice Address - Street 1:12260 SW 8TH ST STE 226
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33184-1549
Practice Address - Country:US
Practice Address - Phone:305-553-0666
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-29
Last Update Date:2025-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL30957122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist