Individual provider Active NPI

Gerald Marc Josephson, D.M.D.

  • Dentist
  • Fort Myers, FL
National Provider Identifier
1184684615
Registry record updated Sep 9, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DN7364 Issued in FL
Practice address
13401 Summerlin Rd Ste 8
Fort Myers, FL 33919-6593
Phone
(239) 415-1880
NPI assigned
Mar 27, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 9, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DS019130L PA
Dentist 122300000X DN7364 FL Primary

Addresses

Primary practice location

13401 Summerlin Rd Ste 8
Fort Myers, FL 33919-6593

Mailing address

5850 Centre Ave
Suite 800C
Pittsburgh, PA 15206-3780
Phone (412) 361-7300

Other practice location 1

5850 Centre Ave
Suite 800c
Pittsburgh, PA 15206-3717
Phone (412) 361-7300

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
DN7364FLMDDentist
DS019130LPAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Coast Dental P.a. Dentist CurrentSince Jun 22, 2021 Accepting new patients
Coast Dental P.a. Dentist PastSince Sep 15, 2019 Accepting new patients

Locations

13401 Summerlin Rd
Ste 8
Fort Myers, FL 33919
Phone (239) 415-1880

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1143417600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1567987200000",
    "number": "1184684615",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5850 CENTRE AVE",
            "address_2": "SUITE 800C",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152063780",
            "telephone_number": "412-361-7300",
            "fax_number": "412-361-4857"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13401 SUMMERLIN RD STE 8",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339196593",
            "telephone_number": "239-415-1880"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5850 Centre Ave",
            "address_2": "Suite 800c",
            "address_purpose": "LOCATION",
            "city": "Pittsburgh",
            "state": "PA",
            "postal_code": "152063717",
            "country_code": "US",
            "telephone_number": "412-361-7300",
            "fax_number": "412-361-4857",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOSEPHSON",
        "first_name": "GERALD",
        "middle_name": "MARC",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-03-27",
        "last_updated": "2019-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "PA",
            "license": "DS019130L",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "DN7364",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Myers, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2019; 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.