Mark R Streater, DMD

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

DN12414 Issued in FL

Practice address

8267 College Parkway
Fort Myers, FL 33919

Phone

(239) 938-3020

Fax

(239) 936-1139

NPI assigned

Mar 25, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Apr 1, 2013 through Apr 1, 2027

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Southwest Florida Oral & Facial Surgery

  • Oral and Maxillofacial Surgery (Dentist)
  • Fort Myers, FL
  • NPI 1649230210
  NPD (past)

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

{
    "created_epoch": "1143244800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1284076800000",
    "number": "1275593980",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8267 COLLEGE PARKWAY",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "33919",
            "telephone_number": "239-938-3020",
            "fax_number": "239-936-1139"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8267 COLLEGE PARKWAY",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "33919",
            "telephone_number": "239-938-3020",
            "fax_number": "239-936-1139"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STREATER",
        "first_name": "MARK",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-25",
        "last_updated": "2010-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "FL",
            "license": "DN12414",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Patrick Stovall, LMT
• Stephanie Stovall, MD
• Christopher P Stowers, MPT
• Sarah Y Strayer, CRNA
• Deborah Senese Streater, D.D.S.
• Cole Ramsey Streets, D.C.
• Erica Anne Streets, ARNP
• Terryn Dione Streets
• Laura Copellman Streyffeler, PH.D.
• Amber Michelle Strianese, RBT

• Oral and Maxillofacial Surgery (Dentist) in Fort Myers, FL
• Providers in Fort Myers, FL by specialty
• Oral and Maxillofacial Surgery (Dentist) in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.