Sally Barth, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DN 10735 Issued in FL

Practice address

15200 S Tamiami TRL
#116
Fort Myers, FL 33908-4297

Phone

(239) 226-9400

NPI assigned

May 18, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Sally Cooley Former name

Medicare fee-for-service enrollment

Enrolled in FL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

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.

• Dunnellon Center for Complete Dentistry PA

  • Dental Clinic/Center
  • Dunnellon, FL
  • NPI 1932781903
  NPD (past)
• Perkins Dentistry, Inc

  • General Practice Dentistry
  • Dunnellon, FL
  • NPI 1578798427
  NPD (past)

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

{
    "created_epoch": "1179446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1536278400000",
    "number": "1295943520",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11653 N. WILLIAMS ST.",
            "city": "DUNNELLON",
            "state": "FL",
            "postal_code": "34432",
            "telephone_number": "352-489-8433"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15200 S TAMIAMI TRL",
            "address_2": "#116",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339084297",
            "telephone_number": "239-226-9400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BARTH",
        "first_name": "SALLY",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-18",
        "last_updated": "2018-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN 10735",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SALLY",
            "last_name": "COOLEY",
            "credential": "DDS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Willis Bon Barrow, MD
• Barry K Butler P.a.
• Megan Marie Barry, D.O.
• Meghan Barry, DC
• Michael Christopher Barry, DO
• Keesha Alexandra Barthelemy, LMHC, CASAC-2
• Shannon Bartz, PHARMD
• Heather Barzo, APRN
• Deborah Tafoya Basford, CM
• Basista & Eldridge DDS PA

• General Practice Dentistry in Fort Myers, FL
• Providers in Fort Myers, FL by specialty
• General Practice Dentistry in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2018; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.