NPIMap

Organization Active NPI

Tim M. Verwest, D.M.D., P.a.

  • Pediatric Dentistry
  • Fort Myers, FL
National Provider Identifier
1457791238
Registry record updated Jun 26, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
DN0012089 Issued in FL
Legal business name
TIM M. VERWEST, D.M.D., P.A.
Practice address
9371 Cypress Lake Dr
Suite 7
Fort Myers, FL 33919-4939
Phone
(239) 482-2722
NPI assigned
Jun 26, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 26, 2013

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

Authorized official

Name
Dr. Tim Verwest, DMDNPI 1013981620
Title
Owner
Phone
(239) 482-2722

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223P0221X DN0012089 FL Primary

Addresses

Primary practice location

9371 Cypress Lake Dr
Suite 7
Fort Myers, FL 33919-4939

Mailing address

9371 Cypress Lake Dr
Suite 7
Fort Myers, FL 33919-4939
Phone (239) 482-2722

Other identifiers 2

IdentifierTypeStateIssuer
073699600MedicaidFL
073699601MedicaidFL

National Provider Directory

National Provider Directory

Locations

8016 Summerlin Lakes Dr
Fort Myers, FL 33907
Phone (239) 482-2722

9371 Cypress Lake Dr
Ste 7
Fort Myers, FL 33919
Phone (239) 482-2722

1035 Piper Blvd
Naples, FL 34110
Phone (239) 333-3200

Practitioners & affiliated clinicians

Practitioners 5

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": "1372204800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1372204800000",
    "number": "1457791238",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9371 CYPRESS LAKE DR",
            "address_2": "SUITE 7",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339194939",
            "telephone_number": "239-482-2722"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9371 CYPRESS LAKE DR",
            "address_2": "SUITE 7",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339194939",
            "telephone_number": "239-482-2722"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TIM M. VERWEST, D.M.D., P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-06-26",
        "last_updated": "2013-06-26",
        "status": "A",
        "authorized_official_last_name": "VERWEST",
        "authorized_official_first_name": "TIM",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "239-482-2722",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "FL",
            "license": "DN0012089",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "073699600",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "073699601",
            "state": "FL"
        }
    ],
    "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 Jun 26, 2013; 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.