Active NPI
Daniel Mandic, DDS
- Dentist
- Estero, FL
National Provider Identifier
1619328796
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- DN28298
- Practice address
- 10151 Estero Town Commons PL Unit 202
Estero, FL 33928-9707 - Phone
- (239) 990-8231
- NPI assigned
- Jun 29, 2016
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | DN28298 | FL | Primary |
| Dentist | 122300000X | 059694 | NY |
Addresses
Primary practice location
10151 Estero Town Commons PL Unit 202
Estero, FL 33928-9707
Mailing address
23 City Park Circle
Woodbridge, ONTARIO L4L 0H2
CA
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 |
|---|---|---|---|
| DN28298 | FL | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1467158400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1689897600000",
"number": "1619328796",
"addresses": [
{
"country_code": "CA",
"country_name": "Canada",
"address_purpose": "MAILING",
"address_type": "FGN",
"address_1": "23 CITY PARK CIRCLE",
"city": "WOODBRIDGE",
"state": "ONTARIO",
"postal_code": "L4L 0H2"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10151 ESTERO TOWN COMMONS PL UNIT 202",
"city": "ESTERO",
"state": "FL",
"postal_code": "339289707",
"telephone_number": "239-990-8231"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MANDIC",
"first_name": "DANIEL",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2016-06-29",
"last_updated": "2023-07-21",
"certification_date": "2022-09-17",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "FL",
"license": "DN28298",
"primary": true
},
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "NY",
"license": "059694",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Estero, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.