Individual provider Active NPI

Yunior Yoel Diaz Sablon, DDS

  • Dentist
  • Fort Myers, FL
National Provider Identifier
1275288714
Registry record updated Jul 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
29396 Issued in FL
Practice address
11741 S Cleveland Ave Ste 50
Fort Myers, FL 33907-2854
Phone
(239) 939-2005
NPI assigned
Feb 14, 2022
Last updated
Jul 16, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Dentist 122300000X 29396 FL Primary

Addresses

Primary practice location

11741 S Cleveland Ave Ste 50
Fort Myers, FL 33907-2854

Mailing address

11741 S Cleveland Ave Ste 30
Fort Myers, FL 33907-2854
Phone (239) 939-2005

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
29396FLMDFamily Medicine Physician

Networks

  • Freedom Health HMO Network

NPI Registry JSON

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

{
    "created_epoch": "1644796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721088000000",
    "number": "1275288714",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11741 S CLEVELAND AVE STE 30",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339072854",
            "telephone_number": "239-939-2005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11741 S CLEVELAND AVE STE 50",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339072854",
            "telephone_number": "239-939-2005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIAZ SABLON",
        "first_name": "YUNIOR",
        "middle_name": "YOEL",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-02-14",
        "last_updated": "2024-07-16",
        "certification_date": "2024-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "29396",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Jul 16, 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.