Active NPI
David Rua Perez
- Prosthodontics
- Naples, FL
National Provider Identifier
1093244972
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Prosthodontics
- License
- DN24959
- Practice address
- 4380 Thomasson Dr
Naples, FL 34112-6725 - Phone
- (470) 990-8713
- NPI assigned
- Jun 5, 2017
- Last updated
- Aug 2, 2022
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Prosthodontics | 1223P0700X | DN24959 | FL | Primary |
| Student in an Organized Health Care Education/Training Program | 390200000X |
Addresses
Primary practice location
4380 Thomasson Dr
Naples, FL 34112-6725
Mailing address
5221 SW 19TH PL
Cape Coral, FL 33914-6819
Phone (786) 328-9108
Other practice location 1
875 Union Ave
Memphis, TN 38103-3513
Phone (786) 328-9108
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
| License | State | Type | Specialty |
|---|---|---|---|
| DN24959 | FL | MD | Prosthodontist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Coast Dental P.a. | Past | Accepting new patients | |
| Coast Dental P.a. | Past | Accepting new patients |
Organizations & group practices 3
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.
-
- Prosthodontics
- Cape Coral, FL
- NPI 1609770197
-
- Dentist
- Tampa, FL
- NPI 1992803860
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1496620800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1659398400000",
"number": "1093244972",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5221 SW 19TH PL",
"city": "CAPE CORAL",
"state": "FL",
"postal_code": "339146819",
"telephone_number": "786-328-9108"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4380 THOMASSON DR",
"city": "NAPLES",
"state": "FL",
"postal_code": "341126725",
"telephone_number": "470-990-8713"
}
],
"practiceLocations": [
{
"address_1": "875 Union Ave",
"address_purpose": "LOCATION",
"city": "Memphis",
"state": "TN",
"postal_code": "381033513",
"country_code": "US",
"telephone_number": "786-328-9108",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "RUA PEREZ",
"first_name": "DAVID",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-06-05",
"last_updated": "2022-08-02",
"certification_date": "2022-08-02",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0700X",
"taxonomy_group": "",
"desc": "Dentist, Prosthodontics",
"state": "FL",
"license": "DN24959",
"primary": true
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Naples, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.