Active NPI
Elena B. Alexiev, DMD
- Dentist
- Fort Myers, FL
National Provider Identifier
1669865721
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- DN21697
- Practice address
- 18070 S. Tamiami Trail
#101
Fort Myers, FL 33908 - Phone
- (239) 236-4820
- NPI assigned
- Mar 13, 2015
- 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 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | DEN.00203330 | CO | |
| General Practice Dentistry | 1223G0001X | DN21697 | FL | |
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Dentist | 122300000X | DN21697 | FL | Primary |
Addresses
Primary practice location
18070 S. Tamiami Trail
#101
Fort Myers, FL 33908
Mailing address
6766 Willow Lake Circle
Fort Myers, FL 33966
Phone (941) 268-8391
Other names 1
- Mrs. Elena B Gaar
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20181016000142 | FL | Order and Referring Only - Dentist | 0042562340 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DEN.00203330 | CO | MD | Dentist |
| DN21697 | FL | MD | General Practice Dentistry |
Networks
- Freedom Health HMO Network
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1426204800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1536105600000",
"number": "1669865721",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6766 WILLOW LAKE CIRCLE",
"city": "FORT MYERS",
"state": "FL",
"postal_code": "33966",
"telephone_number": "941-268-8391"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "18070 S. TAMIAMI TRAIL",
"address_2": "#101",
"city": "FORT MYERS",
"state": "FL",
"postal_code": "33908",
"telephone_number": "239-236-4820"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ALEXIEV",
"first_name": "ELENA",
"middle_name": "B.",
"credential": "DMD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-03-13",
"last_updated": "2018-09-05",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CO",
"license": "DEN.00203330",
"primary": false
},
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "FL",
"license": "DN21697",
"primary": false
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "FL",
"license": "DN21697",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "ELENA",
"last_name": "GAAR",
"middle_name": "B",
"prefix": "MRS.",
"credential": "DMD",
"code": "1",
"type": "Former Name"
}
]
}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 Sep 5, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.