FT MYERS DENTAL SERVICE PA (NPI# 1942492806) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1942492806 |
| Entity Type | Organization |
| Organization Name | FT MYERS DENTAL SERVICE PA |
| Other Organization Name | MAIN STREET ORTHODONTICS OF FT MYERS |
| Practice Address |
6150 Diamond Centre Ct Bldg 300, Suite 2 Fort Myers FL 33912-4365 |
| Mailing Address |
6150 Diamond Center Court Bldg 300, Suite 2 Ft. Myers FL 33912 |
| Practice Telephone | 2397682485 |
| Practice Fax Number | 2394335557 |
| Mailing Telephone | 2397682485 |
| Mailing Fax Number | 2394335557 |
| Enumeration Date | 2007-08-15 |
| Last Update Date | 2007-08-15 |
| Authorized Official Name | MELODY PARRISH (DIRECTOR OF OPERATIONS) |
| Authorized Official Telephone | 3052742499 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223X0400X |
Dentist Specialization: Orthodontics and Dentofacial Orthopedics |
Dental Providers |
| Other Name | Type Code |
|---|---|
| Main Street Orthodontics 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 | 1223X0400X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Orthodontics and Dentofacial Orthopedics |
| That area of dentistry concerned with the supervision, guidance and correction of the growing or mature dentofacial structures, including those conditions that require movement of teeth or correction of malrelationships and malformations of their related structures and the adjustment of relationships between and among teeth and facial bones by the application of forces and/or the stimulation and redirection of functional forces within the craniofacial complex. Major responsibilities of orthodontic practice include the diagnosis, prevention, interception and treatment of all forms of malocclusion of the teeth and associated alterations in their surrounding structures; the design, application and control of functional and corrective appliances; and the guidance of the dentition and its supporting structures to attain and maintain optimum occlusal relations in physiologic and esthetic harmony among facial and cranial structures. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669737086 | John M. Richards | Dentist | 6300 Whiskey Creek Dr, Fort Myers, FL 33919-8710 | 2012-07-11 |
| 1750553806 | Yolanda Kieser | Dentist | 11801 S Cleveland Ave Ste 140, Fort Myers, FL 33907-2977 | 2008-03-28 |
| 1912103128 | Michele B. Laboda | Dentist | 14361 Metropolis Avenue, Ste 1, Fort Myers, FL 33912 | 2007-06-25 |
| 1487789475 | Alan D Shoopak Dmd Orthodontic Group I LLC | Dentist | 7091 College Pkwy, Ste. 16, Fort Myers, FL 33907-5668 | 2007-02-22 |
| 1508474842 | Alexander David Levine | Dentist | 6300 Whiskey Creek Dr, Fort Myers, FL 33919-8710 | 2020-07-22 |
| 1962794602 | Main Street Children's Dentistry and Orthodontics of Ft. Myers, P.a. | Dentist | 13195 Metro Pkwy, Fort Myers, FL 33966-4810 | 2011-05-13 |
| 1194921304 | Michele Laboda Dmd Pa | Dentist | 14361 Metropolis Avenue, Ste 1, Fort Myers, FL 33912 | 2007-06-25 |
| 1093854481 | Jason D Barlock | Dentist | 8595 College Pkwy, Suite B-5, Fort Myers, FL 33919-5191 | 2007-02-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326647215 | Matthew Inaba Pickron | Dentist | 6476 Lake Worth Rd, Lake Worth, FL 33463 | 2020-10-21 |
| 1366056848 | Brandon Lee Zipper | Dentist | 901 N Congress Ave Ste 107, Boynton Beach, FL 33426-3316 | 2020-09-02 |
| 1851903298 | Ocoee Dental & Orthodontics, P.a. | Dentist | 2910 Maguire Rd Ste 1005, Ocoee, FL 34761-4742 | 2020-08-18 |
| 1700411857 | Imagine Orthodontic Studio Pllc | Dentist | 3595 S Florida Ave, Lakeland, FL 33803-4860 | 2020-03-10 |
| 1952933541 | Katherine Kapernaros | Dentist | 1395 Center Dr Rm D7-35, Gainesville, FL 32610-3006 | 2020-02-11 |
| 1609408574 | Ortho 99 Plus 1 | Dentist | 7410 Merrill Road, Suite 2, Jacksonville, FL 32277 | 2020-02-10 |
| 1538709514 | Gardner Orthodontics | Dentist | 518 Hollyberry Lane, Suite 105, Orange Park, FL 32065 | 2020-01-08 |
| 1700421344 | Lindsay A Ringdahl Dmd Ms Pa | Dentist | 85 Weston Rd Unit 102, Weston, FL 33326-1158 | 2019-11-07 |
| 1942844493 | Daniel R Camacho | Dentist | 4330 Sheridan St Ste 201a, Hollywood, FL 33021-1406 | 2019-10-28 |
| 1982247102 | Thebis A. Franceschi | Dentist | 813 Delmar Way Apt 116, Delray Beach, FL 33483-3366 | 2019-10-21 |
| Find all providers with the same taxonomy | ||||
| City | FORT MYERS |
| Zip Code | 33912 |
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| 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.