Scott David Shwedel, DDS

Primary specialty

EndodonticsTaxonomy code 1223E0200X

License

DN 19111 Issued in FL

Practice address

6150 Diamond Centre CT
Building 300, Suite 2
Fort Myers, FL 33912-4365

Phone

(239) 243-9238

Fax

(239) 433-5557

NPI assigned

Feb 12, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Previously, effective Aug 1, 2018 through Aug 1, 2026

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1171238400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1313625600000",
    "number": "1568504140",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6150 DIAMOND CENTRE CT",
            "address_2": "BUILDING 300, SUITE 2",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339124365",
            "telephone_number": "239-243-9238",
            "fax_number": "239-433-5557"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6150 DIAMOND CENTRE CT",
            "address_2": "BUILDING 300, SUITE 2",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339124365",
            "telephone_number": "239-243-9238",
            "fax_number": "239-433-5557"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHWEDEL",
        "first_name": "SCOTT",
        "middle_name": "DAVID",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-12",
        "last_updated": "2011-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MI",
            "license": "2901019441",
            "primary": false
        },
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "FL",
            "license": "DN 19111",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bernard Shucavage, M.D.
• Chloe Maleah Shuck, APRN, CNM
• Lori Mionske Shula, M. A.
• Adam Michael Shuster, DO
• Helene Shute, LCSW
• Sia Medical Center Corp
• Mark A Sibley, MD
• Judy Sicilia, PSY D
• Debra Lee Sicilian, APRN
• Asma Siddiqui, MD

• Endodontics in Fort Myers, FL
• Providers in Fort Myers, FL by specialty
• Endodontics in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.