NPIMap

Organization Active NPI

Dynamic Dental Health Associates of Florida, PA

  • General Practice Dentistry
  • Fort Myers, FL
National Provider Identifier
1265600191
Registry record updated Feb 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
9392 Issued in FL
Legal business name
DYNAMIC DENTAL HEALTH ASSOCIATES OF FLORIDA, PA
Practice address
5180 Palm Beach Blvd
Fort Myers, FL 33905-3270
Phone
(239) 694-6161
Fax
(239) 694-0413
NPI assigned
Feb 13, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 2, 2024

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

Authorized official

Name
Rosa Lesso
Title
Chief Financial Officer
Phone
(714) 571-3471

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223G0001X 9392 FL Primary
Dental Clinic/Center 261QD0000X 9392 FL

Addresses

Primary practice location

5180 Palm Beach Blvd
Fort Myers, FL 33905-3270

Mailing address

136 4TH St N Ste 201
St Petersburg, FL 33701-3889
Phone (727) 800-8026

Other names 1

  • The Smile Studio Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Dynamic Dental Health Associates of Florida13 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

5180 Palm Beach Blvd
Fort Myers, FL 33905
Phone (239) 694-6161

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1202860800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1706832000000",
    "number": "1265600191",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "136 4TH ST N STE 201",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337013889",
            "telephone_number": "727-800-8026",
            "fax_number": "727-304-3164"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5180 PALM BEACH BLVD",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339053270",
            "telephone_number": "239-694-6161",
            "fax_number": "239-694-0413"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DYNAMIC DENTAL HEALTH ASSOCIATES OF FLORIDA, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-13",
        "last_updated": "2024-02-02",
        "certification_date": "2024-02-02",
        "status": "A",
        "authorized_official_last_name": "LESSO",
        "authorized_official_first_name": "ROSA",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "714-571-3471"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "9392",
            "primary": true
        },
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "FL",
            "license": "9392",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Smile Studio",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "The Smile Studio",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Feb 2, 2024; 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.