Individual provider Active NPI

Ivan E Terrero, DDS

  • Dentist
  • Bonita Springs, FL
National Provider Identifier
1720066673
Registry record updated Apr 27, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DN17477 Issued in FL
Practice address
26800 S Tamiami TRL
Suite 350
Bonita Springs, FL 34134-4349
Phone
(239) 676-9696
Fax
(239) 221-7161
NPI assigned
Jan 1, 2006
Last updated
Apr 27, 2009By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 27, 2009

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 043274 NY
Dentist 122300000X DN17477 FL Primary

Addresses

Primary practice location

26800 S Tamiami TRL
Suite 350
Bonita Springs, FL 34134-4349

Mailing address

26800 S Tamiami TRL
Suite 350
Bonita Springs, FL 34134-4349
Phone (239) 676-9696

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)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Better Sleep Florida PA Current Accepting new patients
Ascend Dental Goup PA Current Accepting new patients
Towncare Dental of Bonita Springs PA PastSince Nov 1, 2013 Accepting new patients

Locations

16565 Vanderbilt Dr
Bonita Springs, FL 34134
Phone (239) 322-1262

Networks

  • Freedom Health HMO Network

Organizations & group practices 3

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": "1136073600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1240790400000",
    "number": "1720066673",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26800 S TAMIAMI TRL",
            "address_2": "SUITE 350",
            "city": "BONITA SPRINGS",
            "state": "FL",
            "postal_code": "341344349",
            "telephone_number": "239-676-9696",
            "fax_number": "239-221-7161"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26800 S TAMIAMI TRL",
            "address_2": "SUITE 350",
            "city": "BONITA SPRINGS",
            "state": "FL",
            "postal_code": "341344349",
            "telephone_number": "239-676-9696",
            "fax_number": "239-221-7161"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TERRERO",
        "first_name": "IVAN",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-01-01",
        "last_updated": "2009-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "043274",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "DN17477",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bonita Springs, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2009; 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.