Individual provider Active NPI

Mohammed K Alrubaie, BDS

  • Dentist
  • Fort Myers, FL
National Provider Identifier
1780019885
Registry record updated Nov 6, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DN21613 Issued in FL
Practice address
19001 N Tamiami TRL Ste 4
Fort Myers, FL 33903-7306
Phone
(773) 344-5737
NPI assigned
Sep 8, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 6, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DN21613 FL Primary

Addresses

Primary practice location

19001 N Tamiami TRL Ste 4
Fort Myers, FL 33903-7306

Mailing address

11503 SW 26TH PL Apt 303
Miramar, FL 33025-7545
Phone (773) 344-5737

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160121002357 FL Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 6204139413

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DN21613FLMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1378598400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1446768000000",
    "number": "1780019885",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11503 SW 26TH PL APT 303",
            "city": "MIRAMAR",
            "state": "FL",
            "postal_code": "330257545",
            "telephone_number": "773-344-5737"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19001 N TAMIAMI TRL STE 4",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339037306",
            "telephone_number": "773-344-5737"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALRUBAIE",
        "first_name": "MOHAMMED",
        "middle_name": "K",
        "name_prefix": "Dr.",
        "credential": "BDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-09-08",
        "last_updated": "2015-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "DN21613",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Myers, FL

Sources for this page

Verify at the official NPI Registry.