Individual provider Active NPI

Heydi Perez Reyes

  • General Practice Dentistry
  • Lehigh Acres, FL
National Provider Identifier
1215468103
Registry record updated Sep 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DN27503 Issued in FL
Practice address
2718 Lee Blvd Ste a
Lehigh Acres, FL 33971-1537
Phone
(305) 363-9356
NPI assigned
Mar 23, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 2, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X
General Practice Dentistry 1223G0001X DN27503 FL Primary

Addresses

Primary practice location

2718 Lee Blvd Ste a
Lehigh Acres, FL 33971-1537

Mailing address

9960 Estero Oaks Dr Apt 313
Fort Myers, FL 33967-5312
Phone (305) 363-9356

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
DN27503FLMDGeneral Practice Dentistry

Networks

  • Freedom Health HMO Network

NPI Registry JSON

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

{
    "created_epoch": "1490227200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662076800000",
    "number": "1215468103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9960 ESTERO OAKS DR APT 313",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339675312",
            "telephone_number": "305-363-9356"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2718 LEE BLVD STE A",
            "city": "LEHIGH ACRES",
            "state": "FL",
            "postal_code": "339711537",
            "telephone_number": "305-363-9356"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEREZ REYES",
        "first_name": "HEYDI",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-03-23",
        "last_updated": "2022-09-02",
        "certification_date": "2022-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN27503",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lehigh Acres, FL

Sources for this page

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

Verify at the official NPI Registry.