Active NPI
Connie Brazelton
- Dental Hygienist
- Bonita Springs, FL
National Provider Identifier
1609741347
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dental Hygienist
- License
- DH14978
- Practice address
- 11921 Saradrienne LN
Bonita Springs, FL 34135-5911 - Phone
- (239) 344-2322
- NPI assigned
- Oct 10, 2025
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Dental Hygienist | 124Q00000X | DH14978 | FL | Primary |
Addresses
Primary practice location
11921 Saradrienne LN
Bonita Springs, FL 34135-5911
Mailing address
24165 Red Robin Dr
Bonita Springs, FL 34135-7008
Phone (239) 344-2322
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 |
|---|---|---|---|
| DH14978 | FL | MD | Dental Hygienist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1760054400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1760054400000",
"number": "1609741347",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "24165 RED ROBIN DR",
"city": "BONITA SPRINGS",
"state": "FL",
"postal_code": "341357008",
"telephone_number": "239-344-2322"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11921 SARADRIENNE LN",
"city": "BONITA SPRINGS",
"state": "FL",
"postal_code": "341355911",
"telephone_number": "239-344-2322"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRAZELTON",
"first_name": "CONNIE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2025-10-10",
"last_updated": "2025-10-10",
"certification_date": "2025-10-10",
"status": "A"
},
"taxonomies": [
{
"code": "124Q00000X",
"taxonomy_group": "",
"desc": "Dental Hygienist",
"state": "FL",
"license": "DH14978",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bonita Springs, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.