Individual provider Active NPI

Robert Wade McRee Jr., D.D.S.

  • General Practice Dentistry
  • Indialantic, FL
National Provider Identifier
1265849103
Registry record updated Jul 11, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
3169 Issued in FL
Practice address
102 Tradewinds Ter
Indialantic, FL 32903-3354
Phone
(321) 984-2988
Fax
(321) 984-0464
NPI assigned
Jul 11, 2014
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 11, 2014

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 3169 FL Primary

Addresses

Primary practice location

102 Tradewinds Ter
Indialantic, FL 32903-3354

Mailing address

102 Tradewinds Ter
Indialantic, FL 32903-3354
Phone (321) 984-2988

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
3169FLMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1405036800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1405036800000",
    "number": "1265849103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "102 TRADEWINDS TER",
            "city": "INDIALANTIC",
            "state": "FL",
            "postal_code": "329033354",
            "telephone_number": "321-984-2988",
            "fax_number": "321-984-0464"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 TRADEWINDS TER",
            "city": "INDIALANTIC",
            "state": "FL",
            "postal_code": "329033354",
            "telephone_number": "321-984-2988",
            "fax_number": "321-984-0464"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCREE",
        "first_name": "ROBERT",
        "middle_name": "WADE",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-07-11",
        "last_updated": "2014-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "3169",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Indialantic, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2014; 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.