Individual provider Active NPI

Brittney Atlas, DMD

  • General Practice Dentistry
  • Bonita Springs, FL
National Provider Identifier
1336710185
Registry record updated Jul 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
26175 Issued in FL
Practice address
26831 S Tamiami TRL Unit 48
Bonita Springs, FL 34134-7828
Phone
(239) 948-3200
NPI assigned
Jul 2, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 2, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 26175 FL Primary

Addresses

Primary practice location

26831 S Tamiami TRL Unit 48
Bonita Springs, FL 34134-7828

Mailing address

26831 S Tamiami TRL
Bonita Springs, FL 34134-7823

Other identifiers 1

IdentifierTypeStateIssuer
1336710185MedicaidFL

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20210728002086 FL Order and Referring Only - DentistPractitioner - Dentist 2668875634

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
26175FLMDGeneral Practice Dentistry

Networks

  • Freedom Health HMO Network

NPI Registry JSON

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

{
    "created_epoch": "1625184000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625184000000",
    "number": "1336710185",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26831 S TAMIAMI TRL",
            "city": "BONITA SPRINGS",
            "state": "FL",
            "postal_code": "341347823"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26831 S TAMIAMI TRL UNIT 48",
            "city": "BONITA SPRINGS",
            "state": "FL",
            "postal_code": "341347828",
            "telephone_number": "239-948-3200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ATLAS",
        "first_name": "BRITTNEY",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-07-02",
        "last_updated": "2021-07-02",
        "certification_date": "2021-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "26175",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1336710185",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bonita Springs, FL

Sources for this page

Verify at the official NPI Registry.