Individual provider Active NPI

Parker Joseph Boches, DDS

  • General Practice Dentistry
  • Fort Myers, FL
National Provider Identifier
1669176426
Registry record updated Jun 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DN29066 Issued in FL
Practice address
5037 S Cleveland Ave Ste 102
Fort Myers, FL 33907-1377
Phone
(239) 236-2103
NPI assigned
Mar 28, 2023
Last updated
Jun 18, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DN29066 FL Primary

Addresses

Primary practice location

5037 S Cleveland Ave Ste 102
Fort Myers, FL 33907-1377

Mailing address

2480 First St Apt 448
Fort Myers, FL 33901
Phone (443) 621-8909

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

LicenseStateTypeSpecialty
DN29066FLMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Dentists of Fort Myers PA General Practice CurrentSince Jun 23, 2024 Accepting new patients

Locations

5037 S Cleveland Ave
Ste 102
Fort Myers, FL 33907
Phone (239) 236-2103

Networks

  • Freedom Health HMO Network

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1679961600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718668800000",
    "number": "1669176426",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2480 FIRST ST APT 448",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "33901",
            "telephone_number": "443-621-8909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5037 S CLEVELAND AVE STE 102",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339071377",
            "telephone_number": "239-236-2103"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOCHES",
        "first_name": "PARKER",
        "middle_name": "JOSEPH",
        "name_prefix": "Mr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-03-28",
        "last_updated": "2024-06-18",
        "certification_date": "2024-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN29066",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "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 Jun 18, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.