Individual provider Active NPI

Michael F Ybern

  • Dentist
  • Port St Lucie, FL
National Provider Identifier
1497476618
Registry record updated Oct 4, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
27510 Issued in FL
Practice address
139 SW Port St Lucie Blvd
Port St Lucie, FL 34984-5031
Phone
(772) 878-5000
NPI assigned
Sep 6, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 4, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 27510 FL Primary

Addresses

Primary practice location

139 SW Port St Lucie Blvd
Port St Lucie, FL 34984-5031

Mailing address

461 NW 107TH Ave Apt 2
Miami, FL 33172-7806
Phone (786) 757-7070

Other practice location 1

528 Miracle Mile
Vero Beach, FL 32960-5450
Phone (772) 978-9383

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
27510FLMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Coast Dental P.a. Dentist Past Accepting new patients
Coast Dental P.a. Dentist PastSince Jun 22, 2021 Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1662422400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664841600000",
    "number": "1497476618",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "461 NW 107TH AVE APT 2",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331727806",
            "telephone_number": "786-757-7070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "139 SW PORT ST LUCIE BLVD",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349845031",
            "telephone_number": "772-878-5000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "528 Miracle Mile",
            "address_purpose": "LOCATION",
            "city": "Vero Beach",
            "state": "FL",
            "postal_code": "329605450",
            "country_code": "US",
            "telephone_number": "772-978-9383",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "YBERN",
        "first_name": "MICHAEL",
        "middle_name": "F",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-09-06",
        "last_updated": "2022-10-04",
        "certification_date": "2022-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "27510",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port St Lucie, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 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.