Individual provider Active NPI

Edmond J Allison, DMD

  • General Practice Dentistry
  • Cape Coral, FL
National Provider Identifier
1205277191
Registry record updated Jul 9, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DN0011550 Issued in FL
Practice address
1527 SE 16TH PL
Cape Coral, FL 33990-6845
Phone
(239) 772-5005
Fax
(239) 772-4929
NPI assigned
Jul 9, 2013
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 9, 2013

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 DN0011550 FL Primary

Addresses

Primary practice location

1527 SE 16TH PL
Cape Coral, FL 33990-6845

Mailing address

1527 SE 16TH PL
Cape Coral, FL 33990-6845
Phone (239) 772-5005

Other identifiers 1

IdentifierTypeStateIssuer
1528281755OtherFLNPI ORGANIZATION NUMBER

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
DN0011550FLMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Rafaella Sampaio, DMD, PA PastSince Dec 18, 2022 Accepting new patients
Edmond J Allison DMD PA General Practice Past Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1373328000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1373328000000",
    "number": "1205277191",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1527 SE 16TH PL",
            "city": "CAPE CORAL",
            "state": "FL",
            "postal_code": "339906845",
            "telephone_number": "239-772-5005",
            "fax_number": "239-772-4929"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1527 SE 16TH PL",
            "city": "CAPE CORAL",
            "state": "FL",
            "postal_code": "339906845",
            "telephone_number": "239-772-5005",
            "fax_number": "239-772-4929"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALLISON",
        "first_name": "EDMOND",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-07-09",
        "last_updated": "2013-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN0011550",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI ORGANIZATION NUMBER",
            "identifier": "1528281755",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cape Coral, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2013; 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.