Individual provider Active NPI

Jeffrey E Rubin

  • Oral and Maxillofacial Surgery (Dentist)
  • Fort Myers, FL
National Provider Identifier
1073520789
Registry record updated Mar 5, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
DN12852 Issued in FL
Practice address
3660 Central Ave Ste 14
Fort Myers, FL 33901-8258
Phone
(239) 370-3343
Fax
(239) 320-3288
NPI assigned
Aug 2, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 5, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DN12852 FL
Oral and Maxillofacial Surgery (Dentist) 1223S0112X DN12852 FL Primary

Addresses

Primary practice location

3660 Central Ave Ste 14
Fort Myers, FL 33901-8258

Mailing address

20843 Thistle Leaf LN
Estero, FL 33928-4082
Phone (239) 401-2799

Other identifiers 1

IdentifierTypeStateIssuer
070759700MedicaidFL

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20160513000790 FL Practitioner - Dentist 6103125596 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dentist
Education
New York University College of Dentistry, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

3660 Central Ave
Suite 14
Fort Myers, FL 33901-8258
Phone (239) 401-2799

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DN12852FLMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Picasso Aesthetic and Cosmetic Dental Spa PA Oral and Maxillofacial Surgery CurrentSince May 1, 2009 Accepting new patients

Locations

26649 Dublin Woods Cir
Bonita Springs, FL 34135
Phone (239) 365-5045

3660 Central Ave
Ste 14
Fort Myers, FL 33901
Phone (239) 401-2799

5995 S Pointe Blvd
Ste 109
Fort Myers, FL 33919
Phone (239) 286-9988

6844 International Center Blvd
#A
Fort Myers, FL 33912
Phone (239) 535-9300

4900 W Oakland Park Blvd
Ste 206
Lauderdale Lakes, FL 33313
Phone (954) 306-3481

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1154476800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1772668800000",
    "number": "1073520789",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20843 THISTLE LEAF LN",
            "city": "ESTERO",
            "state": "FL",
            "postal_code": "339284082",
            "telephone_number": "239-401-2799",
            "fax_number": "239-320-3288"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3660 CENTRAL AVE STE 14",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339018258",
            "telephone_number": "239-370-3343",
            "fax_number": "239-320-3288"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUBIN",
        "first_name": "JEFFREY",
        "middle_name": "E",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-02",
        "last_updated": "2026-03-05",
        "certification_date": "2026-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "DN12852",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "FL",
            "license": "DN12852",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "070759700",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Myers, FL

Sources for this page

Verify at the official NPI Registry.