Active NPI
Yareesha Vonshay Sewell-Gray
- Dental Hygienist
- Fort Myers, FL
National Provider Identifier
1619573870
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dental Hygienist
- License
- 22958
- Practice address
- 11600 Gladiolus Dr Ste 102
Fort Myers, FL 33908-4565 - Phone
- (239) 466-9454
- NPI assigned
- Dec 11, 2020
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dental Hygienist | 124Q00000X | DH22958 | FL | |
| Dental Hygienist | 124Q00000X | 22958 | FL | Primary |
Addresses
Primary practice location
11600 Gladiolus Dr Ste 102
Fort Myers, FL 33908-4565
Mailing address
1735 Brantley Rd Apt 911
Fort Myers, FL 33907-3917
Phone (239) 265-1756
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 22958 | Medicaid | FL |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | Yareesha.gray@coastdental.com | Direct |
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 |
|---|---|---|---|
| 22958 | FL | MD | Clinical Social Worker |
| DH22958 | FL | MD | Dental Hygienist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1607644800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1607644800000",
"number": "1619573870",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1735 BRANTLEY RD APT 911",
"city": "FORT MYERS",
"state": "FL",
"postal_code": "339073917",
"telephone_number": "239-265-1756"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11600 GLADIOLUS DR STE 102",
"city": "FORT MYERS",
"state": "FL",
"postal_code": "339084565",
"telephone_number": "239-466-9454"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SEWELL-GRAY",
"first_name": "YAREESHA",
"middle_name": "VONSHAY",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-12-11",
"last_updated": "2020-12-11",
"certification_date": "2020-12-11",
"status": "A"
},
"taxonomies": [
{
"code": "124Q00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Dental Hygienist",
"state": "FL",
"license": "DH22958",
"primary": false
},
{
"code": "124Q00000X",
"taxonomy_group": "",
"desc": "Dental Hygienist",
"state": "FL",
"license": "22958",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "22958",
"state": "FL"
}
],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "Yareesha.gray@coastdental.com",
"affiliation": "N",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "2394669454",
"address_1": "11600 Gladiolus Dr Ste 102",
"city": "Fort Myers",
"state": "FL",
"country_code": "US",
"postal_code": "339084565",
"country_name": "United States",
"address_type": "DOM"
}
],
"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 Dec 11, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.