Active NPI
Kendall Rae Watson, DDS
- Dentist
- Fort Myers, FL
National Provider Identifier
1588457097
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- DN30274
- Practice address
- 4447 Camino Real Way
Fort Myers, FL 33966-1019 - Phone
- (239) 936-7400
- NPI assigned
- May 27, 2025
- Last updated
- Feb 23, 2026
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | DN30274 | FL | Primary |
Addresses
Primary practice location
4447 Camino Real Way
Fort Myers, FL 33966-1019
Mailing address
4312 Coasterra Dr
Fort Myers, FL 33916-8497
Phone (239) 689-9051
Other practice location 1
367 W Hickpochee Ave
LaBelle, FL 33935-4761
Phone (863) 674-0799
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
| License | State | Type | Specialty |
|---|---|---|---|
| DN30274 | FL | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Deirder M Campbell | Dentist | Past | Accepting new patients |
Organizations & group practices 1
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": "1748304000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1771804800000",
"number": "1588457097",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4312 COASTERRA DR",
"city": "FORT MYERS",
"state": "FL",
"postal_code": "339168497",
"telephone_number": "239-689-9051"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4447 CAMINO REAL WAY",
"city": "FORT MYERS",
"state": "FL",
"postal_code": "339661019",
"telephone_number": "239-936-7400"
}
],
"practiceLocations": [
{
"address_1": "367 W Hickpochee Ave",
"address_purpose": "LOCATION",
"city": "LaBelle",
"state": "FL",
"postal_code": "339354761",
"country_code": "US",
"telephone_number": "863-674-0799",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "WATSON",
"first_name": "KENDALL",
"middle_name": "RAE",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2025-05-27",
"last_updated": "2026-02-23",
"certification_date": "2026-02-23",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "FL",
"license": "DN30274",
"primary": true
}
],
"identifiers": [],
"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 Feb 23, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.