FT. MYERS DENTAL SERVICES, PA (NPI# 1437479169) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1437479169 |
| Entity Type | Organization |
| Organization Name | FT. MYERS DENTAL SERVICES, PA |
| Other Organization Name | MAIN STREET CHILDREN'S DENTISTRY OF FT. MYERS |
| Practice Address |
6150 Diamond Centre Ct Bldg 300, Suite 2 Fort Myers FL 33912-4365 |
| Mailing Address |
13195 Sw 134th St 2nd Floor Miami FL 33186-4461 |
| Practice Telephone | 2397682485 |
| Mailing Telephone | 3052742499 |
| Enumeration Date | 2010-06-04 |
| Last Update Date | 2012-07-10 |
| Authorized Official Name | DR. MELVYN GOBER (CEO) |
| Authorized Official Telephone | 3052742499 |
| Authorized Official Credential | DDS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223P0221X |
Dentist Specialization: Pediatric Dentistry |
Dental Providers |
| Other Name | Type Code |
|---|---|
| Main Street Children's Dentistry of Ft. Myers | Doing Business As Name - Organization |
| Street Address |
6150 DIAMOND CENTRE CT BLDG 300, SUITE 2 |
| City | FORT MYERS |
| State | FL |
| Zip Code | 33912-4365 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801892633 | Fred A Liebowitz | Anesthesiology | 6150 Diamond Centre Ct, # 700-1, Fort Myers, FL 33912-4365 | 2005-06-27 |
| 1265984124 | Fred A Liebowitz Md Pa | Anesthesiology | 6150 Diamond Centre Ct, 700-1, Fort Myers, FL 33912-4367 | 2016-10-26 |
| 1972961746 | Anesthesia Specialists of Southern Florida Inc. | Nurse Anesthetist, Certified Registered | 6150 Diamond Centre Ct, Suite 1300, Fort Myers, FL 33912-4368 | 2016-02-08 |
| 1154796126 | Nms Weightloss Clinic I LLC | Family Medicine | 6150 Diamond Centre Ct, Bldg #400, Fort Myers, FL 33912-4368 | 2015-12-02 |
| 1598170979 | Laura Lynn Graff | Speech-Language Pathologist | 6150 Diamond Centre Ct, Suite 203, Fort Myers, FL 33912-4368 | 2014-06-24 |
| 1982036281 | Victoria Jean Dinkins | Occupational Therapist | 6150 Diamond Centre Ct, Fort Myers, FL 33912-4368 | 2013-08-08 |
| 1629417381 | Victor Darien Lubin | Dentist | 6150 Diamond Centre Ct, Fort Myers, FL 33912-4368 | 2013-06-17 |
| 1811336449 | Megan Elizabeth Moran | Speech-Language Pathologist | 6150 Diamond Centre Ct, Suite 203, Fort Myers, FL 33912-4368 | 2013-06-17 |
| 1659716975 | Lee County Physical Medicine LLC | Durable Medical Equipment & Medical Supplies | 6150 Diamond Centre Ct, Suite 1003, Fort Myers, FL 33912-4368 | 2013-04-30 |
| 1811259526 | Jill Lynn Davis | Speech-Language Pathologist | 6150 Diamond Centre Ct, Suite 203, Fort Myers, FL 33912-4368 | 2012-06-10 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134684814 | Performance Health Surgery Center | Clinic/Center | 9500 Gulf Research Lane, Fort Myers, FL 33912 | 2019-02-06 |
| 1609351899 | Voa Lee County Health Care Facility, Inc. | Skilled Nursing Facility | 14750 Hope Center Loop, Ft. Myers, FL 33912 | 2018-10-03 |
| 1245719954 | Lauren Grimes | Pharmacist | 13711 S Tamiami Trail, Fort Myers, FL 33912 | 2018-08-13 |
| 1972080828 | Solaris Rehab, LLC | Clinic/Center | 14001 Metro Parkway, Fort Myers, FL 33912 | 2018-07-24 |
| 1467943803 | Marie Veronica Scott | Nurse Practitioner | 14015 Danpak Loop, Fort Myers, FL 33912 | 2018-05-22 |
| 1952892291 | Daniels Modern Dentistry, Pa | Dentist | 6871 Daniels Parkway, Suite 100, Fort Myers, FL 33912 | 2018-05-22 |
| 1295258994 | Julie Ann Jakobi | Counselor | 18 Quanery Court, Fort Myers, FL 33912 | 2017-07-25 |
| 1205359908 | Maria Reyes | Developmental Therapist | 8961 Daniels Center Drive Suite 401, Fort Myers, FL 33912 | 2017-07-25 |
| 1669919288 | Darinka Ruiz | Social Worker | 961 Daniels Center Drive, Suite 401, Fort Myers, FL 33912 | 2017-01-20 |
| 1730622598 | Valerie Starnes | Nurse Practitioner | 13411 Parker Commons Blvd Ste 101, Fort Myers, FL 33912 | 2016-11-28 |
| Find all providers in zip 33912 | ||||
| Taxonomy Code | 1223P0221X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Pediatric Dentistry |
| An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043665227 | Tong Liu | Dentist | 8016 Summerlin Lakes Dr, Fort Myers, FL 33907 | 2016-04-26 |
| 1538577549 | Joana Lastres | Dentist | 5100 S Cleveland Ave # 315316, Fort Myers, FL 33907-2189 | 2014-07-23 |
| 1841625910 | Midpoint Dentistry | Dentist | 7117 Congdon Rd, Suite 100, Fort Myers, FL 33908-4216 | 2013-09-09 |
| 1598874752 | Oliver Peter Favalli | Dentist | 5150 Mason Corbin Ct, Suite #2, Fort Myers, FL 33907 | 2006-08-30 |
| 1013981620 | Tim M Verwest | Dentist | 9371 Cypress Lake Dr, Suite7, Fort Myers, FL 33919-4939 | 2006-02-13 |
| 1518370360 | Emily Hanna Foster | Dentist | 45 Barkley Cir, Fort Myers, FL 33907-7531 | 2014-06-10 |
| 1457791238 | Tim M. Verwest, D.m.d., P.a. | Dentist | 9371 Cypress Lake Dr, Suite 7, Fort Myers, FL 33919-4939 | 2013-06-26 |
| 1023156247 | Gregory G Hill | Dentist | 45 Barkley Cir, Fort Myers, FL 33907-7531 | 2007-02-01 |
| 1528106747 | Roy V Green | Dentist | 45 Barkley Cir, Fort Myers, FL 33907-7531 | 2007-02-01 |
| 1912045147 | Anissa Ahmadi | Dentist | 45 Barkley Cir, Fort Myers, FL 33907-7531 | 2007-02-01 |
| Find all providers in FORT MYERS | ||||
| City | FORT MYERS |
| Zip Code | 33912 |
Please comment or provide details below to improve the information on FT. MYERS DENTAL SERVICES, PA.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.