Active NPI
Jeffrey Isaias Perez, DMD
- Dentist
- Port Charlotte, FL
National Provider Identifier
1417440280
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- DN23427
- Practice address
- 1750 Tamiami TRL Ste 100
Port Charlotte, FL 33948-1045 - Phone
- (941) 702-2198
- NPI assigned
- Jun 7, 2018
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | DN23427 | FL | Primary |
Addresses
Primary practice location
1750 Tamiami TRL Ste 100
Port Charlotte, FL 33948-1045
Mailing address
23255 Kim Ave
Port Charlotte, FL 33954-3652
Phone (305) 769-8416
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
| License | State | Type | Specialty |
|---|---|---|---|
| DN23427 | FL | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1528329600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1528329600000",
"number": "1417440280",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "23255 KIM AVE",
"city": "PORT CHARLOTTE",
"state": "FL",
"postal_code": "339543652",
"telephone_number": "305-769-8416"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1750 TAMIAMI TRL STE 100",
"city": "PORT CHARLOTTE",
"state": "FL",
"postal_code": "339481045",
"telephone_number": "941-702-2198"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PEREZ",
"first_name": "JEFFREY",
"middle_name": "ISAIAS",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-06-07",
"last_updated": "2018-06-07",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "FL",
"license": "DN23427",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Port Charlotte, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.