Individual provider Active NPI

Edward V Chiarello, D.D.S.

  • Dentist
  • Fort Myers, FL
National Provider Identifier
1023232352
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DN15813 Issued in FL
Practice address
14651 Palm Beach Blvd
Suite 101
Fort Myers, FL 33905-2331
Phone
(239) 694-9993
Fax
(239) 694-9995
NPI assigned
Apr 11, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DN15813 FL Primary

Addresses

Primary practice location

14651 Palm Beach Blvd
Suite 101
Fort Myers, FL 33905-2331

Mailing address

21300 Brinson Ave
Apt 211
Port Charlotte, FL 33952-5046
Phone (941) 743-2250

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
DN15813FLMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Markus Sherry DMD PA Past Accepting new patients
Community Dental Practices, LLC Past Accepting new patients

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/12070/brand/1/csg/1/fhir/r4
  • FHIR API: https://api.platform.athenahealth.com/8796/brand/1/csg/1/fhir/r4

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1176249600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1023232352",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21300 BRINSON AVE",
            "address_2": "APT 211",
            "city": "PORT CHARLOTTE",
            "state": "FL",
            "postal_code": "339525046",
            "telephone_number": "941-743-2250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14651 PALM BEACH BLVD",
            "address_2": "SUITE 101",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339052331",
            "telephone_number": "239-694-9993",
            "fax_number": "239-694-9995"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHIARELLO",
        "first_name": "EDWARD",
        "middle_name": "V",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-11",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "DN15813",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Myers, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.