NPIMap

Organization Active NPI

Florida Dental Team, LLC

  • Pediatric Dentistry
  • Fort Myers, FL
National Provider Identifier
1043925316
Registry record updated Jan 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
Legal business name
FLORIDA DENTAL TEAM, LLC
Practice address
3700 Central Ave Ste 2
Fort Myers, FL 33901-7649
Phone
(239) 387-1587
Fax
(239) 666-7786
NPI assigned
Jan 20, 2023
Organization subpart
Yes
Parent organization
FLORIDA DENTAL TEAM, LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 27, 2025

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

Authorized official

Name
Juan Ojeda
Title
Owner
Phone
(407) 797-1543

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X
Pediatric DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223P0221X Primary

Addresses

Primary practice location

3700 Central Ave Ste 2
Fort Myers, FL 33901-7649

Mailing address

9709 Lakeside Blvd Ste 350
Spring, TX 77381-1213
Phone (713) 489-2198

National Provider Directory

National Provider Directory
Tax ID family
Florida Dental Team LLC4 organizations share this tax ID, including this one
Part of
Florida Dental Team LLC

Other organizations with this tax ID 3

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

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

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

{
    "created_epoch": "1674172800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1737936000000",
    "number": "1043925316",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9709 LAKESIDE BLVD STE 350",
            "city": "SPRING",
            "state": "TX",
            "postal_code": "773811213",
            "telephone_number": "713-489-2198",
            "fax_number": "713-489-2978"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3700 CENTRAL AVE STE 2",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339017649",
            "telephone_number": "239-387-1587",
            "fax_number": "239-666-7786"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FLORIDA DENTAL TEAM, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "FLORIDA DENTAL TEAM, LLC",
        "enumeration_date": "2023-01-20",
        "last_updated": "2025-01-27",
        "certification_date": "2025-01-27",
        "status": "A",
        "authorized_official_last_name": "OJEDA",
        "authorized_official_first_name": "JUAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "407-797-1543"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": null,
            "license": null,
            "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 Jan 27, 2025; 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.