Individual provider Active NPI

Juan Gilberto Zaida Fernandez, DMD

  • Dentist
  • Lehigh Acres, FL
National Provider Identifier
1588406441
Registry record updated Jun 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
29136 Issued in FL
Practice address
2726 4TH St W
Lehigh Acres, FL 33971-1938
Phone
(407) 536-1893
NPI assigned
Jun 11, 2024
Last updated
Jun 21, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 21, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 29136 FL Primary

Addresses

Primary practice location

2726 4TH St W
Lehigh Acres, FL 33971-1938

Mailing address

2726 4TH St W
Lehigh Acres, FL 33971-1938
Phone (407) 536-1893

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
29136FLMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1718064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718928000000",
    "number": "1588406441",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2726 4TH ST W",
            "city": "LEHIGH ACRES",
            "state": "FL",
            "postal_code": "339711938",
            "telephone_number": "407-536-1893"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2726 4TH ST W",
            "city": "LEHIGH ACRES",
            "state": "FL",
            "postal_code": "339711938",
            "telephone_number": "407-536-1893"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZAIDA FERNANDEZ",
        "first_name": "JUAN",
        "middle_name": "GILBERTO",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-06-11",
        "last_updated": "2024-06-21",
        "certification_date": "2024-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "29136",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lehigh Acres, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2024; 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.