Individual provider Active NPI

Alexis Anna Diaczynsky, D.D.S

  • Dentist
  • Naples, FL
National Provider Identifier
1083076004
Registry record updated Aug 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DN22288 Issued in FL
Practice address
3080 Tamiami TRL E Unit 202
Naples, FL 34112-5776
Phone
(239) 732-9000
NPI assigned
Mar 28, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 20, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DN22288 FL Primary

Addresses

Primary practice location

3080 Tamiami TRL E Unit 202
Naples, FL 34112-5776

Mailing address

3080 Tamiami TRL E Unit 202
Naples, FL 34112-5776
Phone (239) 732-9000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20160505002212 NC Order and Referring Only - DentistPractitioner - Dentist 6406155845

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DN22288FLMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Queanh Phan DMD PLLC Past Accepting new patients

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": "1459123200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755648000000",
    "number": "1083076004",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3080 TAMIAMI TRL E UNIT 202",
            "city": "NAPLES",
            "state": "FL",
            "postal_code": "341125776",
            "telephone_number": "239-732-9000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3080 TAMIAMI TRL E UNIT 202",
            "city": "NAPLES",
            "state": "FL",
            "postal_code": "341125776",
            "telephone_number": "239-732-9000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIACZYNSKY",
        "first_name": "ALEXIS",
        "middle_name": "ANNA",
        "name_prefix": "Dr.",
        "credential": "D.D.S",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-03-28",
        "last_updated": "2025-08-20",
        "certification_date": "2025-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "DN22288",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Naples, FL

Sources for this page

Verify at the official NPI Registry.