Individual provider Active NPI

Steven M Frey, D.D.S.

  • Endodontics
  • Fort Myers, FL
National Provider Identifier
1588918767
Registry record updated Aug 5, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
EndodonticsTaxonomy code 1223E0200X
License
2901021139 Issued in MI
Practice address
6323 Corporate CT Ste a
Fort Myers, FL 33919-3518
Phone
(239) 482-5311
Fax
(239) 482-8531
NPI assigned
Nov 9, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endodontics 1223E0200X 2901021139 MI Primary

Addresses

Primary practice location

6323 Corporate CT Ste a
Fort Myers, FL 33919-3518

Mailing address

6323 Corporate CT Ste a
Fort Myers, FL 33919-3518
Phone (239) 482-5311

Other practice location 1

904 Washington Ave
Suite 110
Holland, MI 49423-7724
Phone (616) 392-6385

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170313002070 FL Order and Referring Only - DentistPractitioner - Dentist 4082999081

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2901021139MIMDEndodontist

Practice roles

OrganizationSpecialtyStatusNew patients
Steven M Frey DDS of Naples PLLC Endodontics Current Accepting new patients
Steven M Frey DDS PA Endodontics Current Accepting new patients
Westshore Endodontics PC Endodontics Past Accepting new patients
Westshore Endodontics, P.C. Endodontics Past Accepting new patients

Locations

6323 Corporate Ct
Ste A
Fort Myers, FL 33919
Phone (239) 482-5311

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1352419200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628121600000",
    "number": "1588918767",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6323 CORPORATE CT STE A",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339193518",
            "telephone_number": "239-482-5311"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6323 CORPORATE CT STE A",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339193518",
            "telephone_number": "239-482-5311",
            "fax_number": "239-482-8531"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "904 Washington Ave",
            "address_2": "Suite 110",
            "address_purpose": "LOCATION",
            "city": "Holland",
            "state": "MI",
            "postal_code": "494237724",
            "country_code": "US",
            "telephone_number": "616-392-6385",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FREY",
        "first_name": "STEVEN",
        "middle_name": "M",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-11-09",
        "last_updated": "2021-08-05",
        "certification_date": "2021-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "MI",
            "license": "2901021139",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Myers, FL

Sources for this page

Verify at the official NPI Registry.