Active NPI
Douglas P Bethoney, DMD
- Endodontics
- Brandon, FL
National Provider Identifier
1609897958
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Endodontics
- License
- DN15106
- Practice address
- 625 Eichenfeld Dr
Brandon, FL 33511-5908 - Phone
- (813) 654-3636
- Fax
- (813) 651-4984
- NPI assigned
- Jul 22, 2006
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Endodontics | 1223E0200X | DN15106 | FL | Primary |
Addresses
Primary practice location
625 Eichenfeld Dr
Brandon, FL 33511-5908
Mailing address
421 Islebay Dr
Apollo Beach, FL 33572-3332
Phone (813) 654-3636
Other names 1
- Douglas P Bethoney
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 |
|---|---|---|---|
| DN15106 | FL | MD | Endodontist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Brandon Endodontics, PA | Endodontics | 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 and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153526400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1424304000000",
"number": "1609897958",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "421 ISLEBAY DR",
"city": "APOLLO BEACH",
"state": "FL",
"postal_code": "335723332",
"telephone_number": "813-654-3636",
"fax_number": "813-651-4984"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "625 EICHENFELD DR",
"city": "BRANDON",
"state": "FL",
"postal_code": "335115908",
"telephone_number": "813-654-3636",
"fax_number": "813-651-4984"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BETHONEY",
"first_name": "DOUGLAS",
"middle_name": "P",
"credential": "DMD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-07-22",
"last_updated": "2015-02-19",
"status": "A"
},
"taxonomies": [
{
"code": "1223E0200X",
"taxonomy_group": "",
"desc": "Dentist, Endodontics",
"state": "FL",
"license": "DN15106",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "DOUGLAS",
"last_name": "BETHONEY",
"middle_name": "P",
"credential": "DMD",
"code": "5",
"type": "Other Name"
}
]
}Other providers in Brandon, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.