Individual provider Active NPI

Roger Jacob Pint Jr., D.M.D. M.P.H.

  • General Practice Dentistry
  • Bonita Springs, FL
National Provider Identifier
1104070770
Registry record updated Dec 12, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DN 18908 Issued in FL
Practice address
9200 Bonita Beach Rd SE
Suite 111
Bonita Springs, FL 34135-4280
Phone
(239) 676-8730
NPI assigned
Nov 10, 2008
Last updated
Dec 12, 2011By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 12, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DN 18908 FL Primary

Addresses

Primary practice location

9200 Bonita Beach Rd SE
Suite 111
Bonita Springs, FL 34135-4280

Mailing address

9200 Bonita Beach Rd SE
Suite 111
Bonita Springs, FL 34135-4280
Phone (239) 676-8730

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

LicenseStateTypeSpecialty
DN 18908FLMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1226275200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1323648000000",
    "number": "1104070770",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9200 BONITA BEACH RD SE",
            "address_2": "SUITE 111",
            "city": "BONITA SPRINGS",
            "state": "FL",
            "postal_code": "341354280",
            "telephone_number": "239-676-8730"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9200 BONITA BEACH RD SE",
            "address_2": "SUITE 111",
            "city": "BONITA SPRINGS",
            "state": "FL",
            "postal_code": "341354280",
            "telephone_number": "239-676-8730"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PINT",
        "first_name": "ROGER",
        "middle_name": "JACOB",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "D.M.D.  M.P.H.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-11-10",
        "last_updated": "2011-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN 18908",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bonita Springs, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2011; 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.