Jonathan Van Dyke, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

DN22095 Issued in FL

Practice address

606 Bald Eagle Dr Ste 200
Marco Island, FL 34145-2731

Phone

(239) 394-1004

NPI assigned

Jul 12, 2016

Last updated

Apr 20, 2023By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

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.

• Safari Smiles Children Dentistry, LLC

  dba Safari Smiles Children's Dentistry

  • Pediatric Dentistry
  • Bonita Springs, FL
  • NPI 1164259511
  NPD Authorized official
• Island Tower Dentistry PA

  dba Island Tower Dentistry

  • General Practice Dentistry
  • Marco Island, FL
  • NPI 1154016178
  Authorized official Same address or phone
• Comfortable Care Dental Health Professionals, P.a.

  dba Brooker Creek Dental Group

  • General Practice Dentistry
  • Palm Harbor, FL
  • NPI 1114317294
  NPD (past)

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

{
    "created_epoch": "1468281600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681948800000",
    "number": "1063864270",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "606 BALD EAGLE DR STE 200",
            "city": "MARCO ISLAND",
            "state": "FL",
            "postal_code": "341452731",
            "telephone_number": "239-394-1004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "606 BALD EAGLE DR STE 200",
            "city": "MARCO ISLAND",
            "state": "FL",
            "postal_code": "341452731",
            "telephone_number": "239-394-1004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAN DYKE",
        "first_name": "JONATHAN",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-07-12",
        "last_updated": "2023-04-20",
        "certification_date": "2023-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "DN22095",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Erlvinnice Baron Tuanson
• Tyler Frey DMD PA (Coastal Smiles Dental Care)
• Jenna Urena
• Alondra Valdovinos
• Angela Valenzuela
• Anaiya Loree Vaughn
• Adrianna Vega-Alcantar
• Joseph P Vickaryous, D.O.
• Alexcia Vo
• Deziree Joan Wagner

• Dentist in Marco Island, FL
• Providers in Marco Island, FL by specialty
• Dentist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.