NPIMap

Collier Health Services Inc

Organization Active NPI Pediatric Dentistry · Immokalee, FL

NPI 1003065723 · NPPES record last updated Nov 10, 2021

Key facts

NPI
1003065723
Entity type
Organization (NPI type 2)
Primary specialty
Pediatric Dentistry 1223P0221X
Legal business name
COLLIER HEALTH SERVICES INC
Practice address
1454 Madison Ave W
Immokalee, FL 34142-2200
Phone
(239) 658-3064
Fax
(239) 658-3175
NPI assigned
Sep 18, 2008
Organization subpart
No

Authorized official

Name
Sandra Steele
Title
Chief Financial Officer
Phone
(239) 658-3003

Corporate family (same tax ID) 12

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

National Provider Directory

Tax ID family
Collier Health Services Central Naples Pediatrics (79 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Endodontics
Group: 193400000X MULTIPLE SINGLE SPECIALTY GROUP		 1223E0200X
Pediatric Dentistry
Group: 193400000X MULTIPLE SINGLE SPECIALTY GROUP		 1223P0221X Yes
Periodontics
Group: 193400000X MULTIPLE SINGLE SPECIALTY GROUP		 1223P0300X
Dental Hygienist
Group: 193400000X MULTIPLE SINGLE SPECIALTY GROUP		 124Q00000X
Dental Assistant
Group: 193400000X MULTIPLE SINGLE SPECIALTY GROUP		 126800000X
Federally Qualified Health Center (FQHC) 261QF0400X

Addresses

Primary practice location

1454 Madison Ave W
Immokalee, FL 34142-2200

Mailing address

7007 Lely Cultural Pkwy
Edison College Building L
Naples, FL 34113-8976
Phone (239) 775-3052

Other names

  • CHS-UF Pediatric Dental Center Doing business as

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Nov 10, 2021.

{
    "created_epoch": "1221696000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1636502400000",
    "number": "1003065723",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7007 LELY CULTURAL PKWY",
            "address_2": "EDISON COLLEGE BUILDING L",
            "city": "NAPLES",
            "state": "FL",
            "postal_code": "341138976",
            "telephone_number": "239-775-3052",
            "fax_number": "239-775-7035"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1454 MADISON AVE W",
            "city": "IMMOKALEE",
            "state": "FL",
            "postal_code": "341422200",
            "telephone_number": "239-658-3064",
            "fax_number": "239-658-3175"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLLIER HEALTH SERVICES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-09-18",
        "last_updated": "2021-11-10",
        "certification_date": "2021-11-10",
        "status": "A",
        "authorized_official_last_name": "STEELE",
        "authorized_official_first_name": "SANDRA",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "239-658-3003"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, Endodontics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "1223P0300X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, Periodontics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "124Q00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dental Hygienist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "126800000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dental Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CHS-UF Pediatric Dental Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Immokalee, FL

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Sources for this page

Verify at the official NPI Registry.