MAIN STREET CHILDREN'S DENTISTRY AND ORTHODONTICS OF FT. MYERS, P.A. (NPI# 1962794602) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1962794602 |
| Entity Type | Organization |
| Organization Name | MAIN STREET CHILDREN'S DENTISTRY AND ORTHODONTICS OF FT. MYERS, P.A. |
| Practice Address |
13195 Metro Pkwy Fort Myers FL 33966-4810 |
| Mailing Address |
13195 Sw 134th St Fl 2 Miami FL 33186-4461 |
| Practice Telephone | 2397682485 |
| Mailing Telephone | 3052742499 |
| Mailing Fax Number | 3052749312 |
| Enumeration Date | 2011-05-13 |
| Last Update Date | 2014-08-01 |
| Authorized Official Name | STEPHANIE GOMEZ (PROVIDER RELATIONS SPECIALIST) |
| Authorized Official Telephone | 3052742499 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 1223X0400X |
Dentist Specialization: Orthodontics and Dentofacial Orthopedics |
Dental Providers | ||
| N | 122300000X | Dentist | Dental Providers | ||
| Y | 1223P0221X |
Dentist Specialization: Pediatric Dentistry |
Dental Providers |
| Street Address |
13195 METRO PKWY |
| City | FORT MYERS |
| State | FL |
| Zip Code | 33966-4810 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417945890 | Bonnie Shepheard | Advanced Practice Midwife | 13195 Metro Pkwy, Units 6-9, Fort Myers, FL 33966-4810 | 2005-10-11 |
| 1871001370 | Sara Shanahan | Advanced Practice Midwife | 13195 Metro Pkwy, Fort Myers, FL 33966-4810 | 2018-01-18 |
| 1548633860 | Catharina Williams | Advanced Practice Midwife | 13195 Metro Pkwy, #6-9, Fort Myers, FL 33966-4810 | 2015-11-09 |
| 1609253871 | Cindy Pohner | Advanced Practice Midwife | 13195 Metro Pkwy, Fort Myers, FL 33966-4810 | 2015-04-27 |
| 1386063238 | Kristen Marie Turner | Obstetrics & Gynecology | 13195 Metro Pkwy, Fort Myers, FL 33966-4810 | 2014-04-08 |
| 1043505332 | Alexander Gumiroff | Obstetrics & Gynecology | 13195 Metro Pkwy, #6-9, Fort Myers, FL 33966-4810 | 2011-06-14 |
| 1508909920 | Mary Beth Weimer | Midwife | 13195 Metro Pkwy, #6-9, Fort Myers, FL 33966-4810 | 2007-02-15 |
| 1780693291 | Barbara J Carroll | Advanced Practice Midwife | 13195 Metro Pkwy, Unit 6-9, Fort Myers, FL 33966-4810 | 2006-08-05 |
| 1497793244 | Jeffry Lee Garner | Obstetrics & Gynecology | 13195 Metro Pkwy, Suites 6-9, Fort Myers, FL 33966-4810 | 2006-06-03 |
| 1114988391 | Martha A Mckaig Linnemeyer | Advanced Practice Midwife | 13195 Metro Pkwy, Ste 6-9, Fort Myers, FL 33966-4810 | 2006-03-29 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962989566 | Samarah A Al-jamali | Dentist | 9330 Ben Pratt/6 Mi Cypress #4, Fort Myers, FL 33966 | 2018-07-26 |
| 1932646171 | Jose M Butron | Behavioral Analyst | 6430 Plantation Park Ct Ste 200, Fort Myers, FL 33966 | 2017-01-26 |
| 1003276833 | Katia Jasmin Robinson Lucero | Social Worker | 3820 Colonial Blvd Suite #102, Fort Myers, FL 33966 | 2016-03-07 |
| 1578947610 | Christian Milanes | Dentist | 9330 Ben C. Pratt Six Mile Cypress Pkwy, Fort Myers, FL 33966 | 2015-07-18 |
| 1003166273 | Reetane Singh | Dentist | 9330 Ben C Pratt Six Mile, Cypress Parkway, Fort Myers, FL 33966 | 2012-09-14 |
| 1518216159 | Lee Mental Health Center | Community Based Residential Treatment Facility, Mental Illness | 10140 Deer Run Farms Road, Fort Myers, FL 33966 | 2012-08-29 |
| 1033482724 | Planned Parenthood of Southwest and Central Florida Inc. | Obstetrics & Gynecology | 6418 Commerce Park Drive, Fort Myers, FL 33966 | 2012-02-11 |
| 1013292291 | J Kru Therapy LLC Dba Focus | Physical Therapist | 4997 Royal Gulf Cir, Fort Myers, FL 33966 | 2011-10-19 |
| 1528354651 | American In-home Care, LLC | Home Health | 3800 Colonial Blvd Unit 102, Fort Myers, FL 33966 | 2011-06-27 |
| 1811219256 | Vera Marie Rosado-odom | Internal Medicine | 13340 Metro Pkwy Ste 310, Fort Myers, FL 33966 | 2010-02-26 |
| Find all providers in zip 33966 | ||||
| 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 |
| 1437479169 | Ft. Myers Dental Services, Pa | Dentist | 6150 Diamond Centre Ct, Bldg 300, Suite 2, Fort Myers, FL 33912-4365 | 2010-06-04 |
| 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 |
| Find all providers in FORT MYERS | ||||
| City | FORT MYERS |
| Zip Code | 33966 |
Please comment or provide details below to improve the information on MAIN STREET CHILDREN'S DENTISTRY AND ORTHODONTICS OF FT. MYERS, P.A..
| 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.