NPIMap

Organization Active NPI

Florida Dental Professionals, P.a.

Doing business as Naples Periodontist

  • General Practice Dentistry
  • Naples, FL
National Provider Identifier
1245709641
Registry record updated May 2, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
FLORIDA DENTAL PROFESSIONALS, P.A.
Doing business as
Naples Periodontist
Practice address
4933 Tamiami TRL N Ste 100
Naples, FL 34103-3028
Phone
(217) 540-5100
NPI assigned
Nov 15, 2018
Last updated
May 2, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 2, 2019

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

Authorized official

Name
Kendra Walker
Title
Enrollment Team Lead
Phone
(217) 540-8513

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X Primary

Addresses

Primary practice location

4933 Tamiami TRL N Ste 100
Naples, FL 34103-3028

Mailing address

4933 Tamiami TRL N Ste 100
Naples, FL 34103-3028
Phone (217) 540-5100

Other names 1

  • Naples Periodontist Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Florida Dental Professionals PA13 organizations share this tax ID, including this one

Other organizations with this tax ID 12

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

Locations

4933 Tamiami Trl N
Ste 100
Naples, FL 34103
Phone (239) 649-7766

Ownership & related parties

Subparts reporting this organization as parent 10

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

NPI Registry JSON

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

{
    "created_epoch": "1542240000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1556755200000",
    "number": "1245709641",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4933 TAMIAMI TRL N STE 100",
            "city": "NAPLES",
            "state": "FL",
            "postal_code": "341033028",
            "telephone_number": "217-540-5100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4933 TAMIAMI TRL N STE 100",
            "city": "NAPLES",
            "state": "FL",
            "postal_code": "341033028",
            "telephone_number": "217-540-5100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FLORIDA DENTAL PROFESSIONALS, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-11-15",
        "last_updated": "2019-05-02",
        "status": "A",
        "authorized_official_last_name": "WALKER",
        "authorized_official_first_name": "KENDRA",
        "authorized_official_title_or_position": "ENROLLMENT TEAM LEAD",
        "authorized_official_telephone_number": "217-540-8513"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Naples Periodontist",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Naples, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 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.