Estero General Dentistry LLC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

ESTERO GENERAL DENTISTRY LLC

Doing business as

Coastal Smiles

Practice address

21301 S Tamiami TRL Ste 350
Estero, FL 33928-2944

Phone

(239) 948-1990

NPI assigned

Oct 17, 2022

Last updated

Oct 17, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Tyler Frey, DMDNPI 1073160669

Title

Authorized Member

Phone

(810) 845-9695

Specialties & licenses 1

Addresses

Other names 1

• Coastal Smiles Doing business as

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Tyler Frey, DMD

  • General Practice Dentistry
  • Marco Island, FL
  • NPI 1073160669
  NPD (past) Authorized official
• Steven Lee Knepper, DDS

  • Dentist
  • Estero, FL
  • NPI 1619036027
  NPD (past)

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

{
    "created_epoch": "1665964800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1665964800000",
    "number": "1447976857",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21301 S TAMIAMI TRL STE 350",
            "city": "ESTERO",
            "state": "FL",
            "postal_code": "339282944",
            "telephone_number": "239-948-1990"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21301 S TAMIAMI TRL STE 350",
            "city": "ESTERO",
            "state": "FL",
            "postal_code": "339282944",
            "telephone_number": "239-948-1990"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ESTERO GENERAL DENTISTRY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-10-17",
        "last_updated": "2022-10-17",
        "certification_date": "2022-10-17",
        "status": "A",
        "authorized_official_last_name": "FREY",
        "authorized_official_first_name": "TYLER",
        "authorized_official_title_or_position": "AUTHORIZED MEMBER",
        "authorized_official_telephone_number": "810-845-9695",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Coastal Smiles",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Sarah Escamilla, RN, IBCLC
• Estero Bay Dental, PLLC
• Estero Dermatology & Skin Surgery Center, LLC (Houck Dermatology)
• Estero Eyecare
• Estero Family Chiropractic LLC
• Estero Retina
• Estero Smiles Dentistry, PA (Estero Smiles Dentistry)
• Ernesto Alberto Eusebio Morales, M.D.
• Evolv Behavior, LLC
• Elyse Dyan Ewig, AUD

• Dental Clinic/Center in Estero, FL
• Providers in Estero, FL by specialty
• Dental Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2022; 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.