MODERN DENTAL CAPE CORAL PLLC (NPI# 1437785847) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1437785847 |
| Entity Type | Organization |
| Organization Name | MODERN DENTAL CAPE CORAL PLLC |
| Practice Address |
706 Sw Pine Island Rd Suite 103 Cape Coral FL 33991 |
| Mailing Address |
14575 Tamiami Trl Ste A North Port FL 34287-2743 |
| Practice Telephone | 9416106200 |
| Mailing Telephone | 9418882362 |
| Enumeration Date | 2020-03-17 |
| Last Update Date | 2020-03-17 |
| Authorized Official Name | TYLER M BLACKENBURG (PERIODONTIST) |
| Authorized Official Telephone | 9547367924 |
| Authorized Official Credential | DMD |
| Is Organization Subpart | Y |
| Parent Organization Name | MODERN DENTAL, LLC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 1223P0300X |
Dentist Specialization: Periodontics |
Dental Providers | ||
| Y | 1223G0001X |
Dentist Specialization: General Practice |
Dental Providers |
| Street Address |
706 SW PINE ISLAND RD SUITE 103 |
| City | CAPE CORAL |
| State | FL |
| Zip Code | 33991 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518593367 | Sand Vision LLC | Technician/Technologist | 706 Sw Pine Island Rd # 102, Cape Coral, FL 33991 | 2020-03-12 |
| 1518509975 | Neliudis Navarro Lores | Nurse Practitioner | 1814 Sw 23rd Ct, Cape Coral, FL 33991 | 2019-10-16 |
| 1487117388 | Johner Therapy Inc | Physical Therapist | 58 Nicholas Pkwy W #105, Cape Coral, FL 33991 | 2019-04-09 |
| 1184176901 | Gerta Avdia | Pharmacist | 611 Old Burnt Store Rd South, Cape Coral, FL 33991 | 2016-10-27 |
| 1285038109 | Sams East Inc | Durable Medical Equipment & Medical Supplies | 301 Sw Pine Island Road, Cape Coral, FL 33991 | 2014-10-21 |
| 1225442676 | Gulf Coast Family Care, Plc | Nurse Practitioner | 814 Sw Pine Island Road, Suite 306, Cape Coral, FL 33991 | 2014-06-13 |
| 1760731848 | Florida Alf, Inc | Clinic/Center | 1318 Santa Barbara Blvd, Cape Coral, FL 33991 | 2012-09-05 |
| 1952574832 | Michael Anthony Fritz | Physical Therapist | 517 S.w. 8th Street, Cape Coral, FL 33991 | 2008-04-10 |
| 1306982350 | Dawn Marie Galbreath | Registered Nurse | 1002 Sw 9th Avenue, Cape Coral, FL 33991 | 2007-01-29 |
| 1316937485 | Demetrios Gonis | Internal Medicine | 290 Nw Nicholas Pkwy, Suite 1, Cape Coral, FL 33991 | 2005-10-28 |
| Find all providers in zip 33991 | ||||
| Taxonomy Code | 1223G0001X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | General Practice |
| A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. |
| Notes: Source: Academy of General Dentistry |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720629603 | Comfortable Care Dental Health Professionals, P.a. | Dentist | 541 Sw Pine Island Rd, Cape Coral, FL 33991-1962 | 2019-10-02 |
| 1912492364 | Tyler Wayne Phillips | Dentist | 305 Sw Pine Island Rd Unit 1, Cape Coral, FL 33991-2044 | 2018-06-28 |
| 1598294753 | Annie Diaz | Dentist | 2529 Santa Barbara Blvd Ste 100, Cape Coral, FL 33914-4447 | 2017-06-09 |
| 1013379635 | Comfortable Care Dental Health Professionals, Pa | Dentist | 2529 Santa Barbara Blvd, Suite 100, Cape Coral, FL 33914-4455 | 2016-03-23 |
| 1629365937 | Todays Dental of Swfl Inc | Dentist | 1501 Viscaya Pkwy Ste 1, Cape Coral, FL 33990-6226 | 2011-07-07 |
| 1407143415 | Heather Danielle Palmer | Dentist | 521 Cape Coral W Pkwy, Cape Coral, FL 33914-8507 | 2011-06-29 |
| 1881821858 | John Francis Pelland | Dentist | 2002 Del Prado Blvd., Ste 202, Cape Coral, FL 33990-4557 | 2009-06-17 |
| 1790947984 | Michael H Mcmillan Dmd, Pa | Dentist | 4215 Del Prado Blvd S, Cape Coral, FL 33904-7167 | 2008-06-28 |
| 1255508776 | Timothy L Snyder Dds Pa | Dentist | 4113 Del Prado Blvd South, Cape Coral, FL 33904 | 2008-05-14 |
| 1558572990 | Todd Sharp | Dentist | 1227 Del Prado Blvd S, Suite 107, Cape Coral, FL 33990-3631 | 2007-05-25 |
| Find all providers in CAPE CORAL | ||||
| City | CAPE CORAL |
| Zip Code | 33991 |
Please comment or provide details below to improve the information on MODERN DENTAL CAPE CORAL PLLC.
| 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.