Provider Demographics
NPI:1760639157
Name:PRITZ, RANDY FREDERICK (DMD)
Entity type:Individual
Prefix:DR
First Name:RANDY
Middle Name:FREDERICK
Last Name:PRITZ
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 ISLAND AVE APT 5D
Mailing Address - Street 2:
Mailing Address - City:MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33139-1333
Mailing Address - Country:US
Mailing Address - Phone:609-442-8305
Mailing Address - Fax:
Practice Address - Street 1:30 5TH AVE APT 1G
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10011-8804
Practice Address - Country:US
Practice Address - Phone:212-673-3700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-08-27
Last Update Date:2025-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYP642811223G0001X, 122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223G0001XDental ProvidersDentistGeneral Practice