Organization Active NPI

Towncare Dental of Bonita Springs, P.a

  • General Practice Dentistry
  • Bonita Springs, FL
National Provider Identifier
1174948723
Registry record updated Aug 6, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
TOWNCARE DENTAL OF BONITA SPRINGS, P.A
Practice address
16565 Vanderbilt Dr
Bonita Springs, FL 34134-7552
Phone
(239) 498-6780
NPI assigned
Feb 19, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 6, 2014

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

Authorized official

Name
Stephanie Gomez
Title
Provider Relations Specialist
Phone
(305) 274-2499

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
EndodonticsGroup: 193200000X MULTI-SPECIALTY GROUP 1223E0200X
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X Primary
Pediatric DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223P0221X
Oral and Maxillofacial Surgery (Dentist)Group: 193200000X MULTI-SPECIALTY GROUP 1223S0112X

Addresses

Primary practice location

16565 Vanderbilt Dr
Bonita Springs, FL 34134-7552

Mailing address

13195 SW 134 St
2ND Floor
Miami, FL 33186
Phone (305) 274-2499

National Provider Directory

National Provider Directory
Tax ID family
Main Street Children'S Dentistry of Bonita Springs2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1392768000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1407283200000",
    "number": "1174948723",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13195 SW 134 ST",
            "address_2": "2ND FLOOR",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "33186",
            "telephone_number": "305-274-2499"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16565 VANDERBILT DR",
            "city": "BONITA SPRINGS",
            "state": "FL",
            "postal_code": "341347552",
            "telephone_number": "239-498-6780"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TOWNCARE DENTAL OF BONITA SPRINGS, P.A",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-02-19",
        "last_updated": "2014-08-06",
        "status": "A",
        "authorized_official_last_name": "GOMEZ",
        "authorized_official_first_name": "STEPHANIE",
        "authorized_official_title_or_position": "PROVIDER RELATIONS SPECIALIST",
        "authorized_official_telephone_number": "305-274-2499"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Endodontics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "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 Aug 6, 2014; 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.