Individual provider Active NPI

Indira M Sanchez Concepcion

  • Dentist
  • Fort Myers, FL
National Provider Identifier
1407550924
Registry record updated May 23, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DN27892 Issued in FL
Practice address
18990 S Tamiami TRL Ste 110
Fort Myers, FL 33908-4737
Phone
(239) 482-2296
NPI assigned
Mar 28, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 23, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DN27892 FL Primary

Addresses

Primary practice location

18990 S Tamiami TRL Ste 110
Fort Myers, FL 33908-4737

Mailing address

8862 NW 110TH LN
Hialeah Gardens, FL 33018-4557

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
DN27892FLMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Coast Florida P.a. Dentist CurrentSince Apr 6, 2023 Accepting new patients
Coast Florida P.a. Dentist PastSince Apr 6, 2023 Accepting new patients

Locations

18990 S Tamiami Trl
Ste 110
Fort Myers, FL 33908
Phone (239) 482-2296

Networks

  • Freedom Health HMO Network

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1679961600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684800000000",
    "number": "1407550924",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8862 NW 110TH LN",
            "city": "HIALEAH GARDENS",
            "state": "FL",
            "postal_code": "330184557"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18990 S TAMIAMI TRL STE 110",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339084737",
            "telephone_number": "239-482-2296"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANCHEZ CONCEPCION",
        "first_name": "INDIRA",
        "middle_name": "M",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-03-28",
        "last_updated": "2023-05-23",
        "certification_date": "2023-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "DN27892",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Myers, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2023; 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.