Tracy Lynn Couillard, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

DN24195 Issued in FL

Practice address

8800 Bernwood Pkwy Ste 4
Bonita Springs, FL 34135-9527

Phone

(239) 949-1805

NPI assigned

Jul 18, 2019

Sex

Female

Sole proprietor

Yes

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

Medicare enrollment (NPD)

Not 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.

• Melanie Pugh DMD, P.a. - GP

  • General Practice Dentistry
  • Bonita Springs, FL
  • NPI 1821449976
  NPD (past)

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

{
    "created_epoch": "1563408000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1563408000000",
    "number": "1306499447",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8800 BERNWOOD PKWY STE 4",
            "city": "BONITA SPRINGS",
            "state": "FL",
            "postal_code": "341359527"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8800 BERNWOOD PKWY STE 4",
            "city": "BONITA SPRINGS",
            "state": "FL",
            "postal_code": "341359527",
            "telephone_number": "239-949-1805"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COUILLARD",
        "first_name": "TRACY",
        "middle_name": "LYNN",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-07-18",
        "last_updated": "2019-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "DN24195",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Charlton Cook, PH.D., N.D.
• Cora Health Services Inc
• Corrective Spinal Care of Florida 3, P.a.
• Julie Marie Cosmello, RPH
• Zahilyn Cote, L.M.T.
• Kelsey Diane Craft, PA-C
• Bennett Crawford, CCC-SLP
• Creative Island Therapy, LLC
• Evelyn Critchfield, D.M.D
• Renee Crivello, BCBA

• Dentist in Bonita Springs, FL
• Providers in Bonita Springs, FL by specialty
• Dentist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2019; 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.