Organization Active NPI

Riverview Endodontics LLC

  • Endodontics
  • Bonita Springs, FL
National Provider Identifier
1326872417
Registry record updated Aug 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
EndodonticsTaxonomy code 1223E0200X
Legal business name
RIVERVIEW ENDODONTICS LLC
Practice address
27399 Riverview Center Blvd Ste 104
Bonita Springs, FL 34134-4311
Phone
(239) 408-3636
NPI assigned
Aug 29, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 29, 2024

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

Authorized official

Name
Dr. Ingmar Andrea Hernandez, DMDNPI 1538721006
Title
Owner Dentist
Phone
(239) 408-3636

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
EndodonticsGroup: 193200000X MULTI-SPECIALTY GROUP 1223E0200X Primary
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X

Addresses

Primary practice location

27399 Riverview Center Blvd Ste 104
Bonita Springs, FL 34134-4311

Mailing address

27399 Riverview Center Blvd Ste 104
Bonita Springs, FL 34134-4311
Phone (239) 408-3636

Other identifiers 1

IdentifierTypeStateIssuer
DN24712OtherFLDENTAL LICENSE

National Provider Directory

National Provider Directory

Locations

27399 Riverview Center Blvd
Ste 104
Bonita Springs, FL 34134
Phone (239) 408-3636

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1724889600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1724889600000",
    "number": "1326872417",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27399 RIVERVIEW CENTER BLVD STE 104",
            "city": "BONITA SPRINGS",
            "state": "FL",
            "postal_code": "341344311",
            "telephone_number": "239-408-3636"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27399 RIVERVIEW CENTER BLVD STE 104",
            "city": "BONITA SPRINGS",
            "state": "FL",
            "postal_code": "341344311",
            "telephone_number": "239-408-3636"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RIVERVIEW ENDODONTICS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-08-29",
        "last_updated": "2024-08-29",
        "certification_date": "2024-08-29",
        "status": "A",
        "authorized_official_last_name": "HERNANDEZ",
        "authorized_official_first_name": "INGMAR",
        "authorized_official_middle_name": "ANDREA",
        "authorized_official_title_or_position": "OWNER DENTIST",
        "authorized_official_telephone_number": "239-408-3636",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Endodontics",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DENTAL LICENSE",
            "identifier": "DN24712",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bonita Springs, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 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.