Gustavo Enrique Fuentes, D.M.D.

Primary specialty

EndodonticsTaxonomy code 1223E0200X

License

DN12498 Issued in FL

Practice address

13650 Metropolis Ave
Suite 106
Fort Myers, FL 33912-4375

Phone

(239) 561-3636

Fax

(239) 561-3699

NPI assigned

Nov 15, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1163548800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1861564429",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13650 METROPOLIS AVE",
            "address_2": "SUITE 106",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339124375",
            "telephone_number": "239-561-3636",
            "fax_number": "239-561-3699"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13650 METROPOLIS AVE",
            "address_2": "SUITE 106",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339124375",
            "telephone_number": "239-561-3636",
            "fax_number": "239-561-3699"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FUENTES",
        "first_name": "GUSTAVO",
        "middle_name": "ENRIQUE",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-15",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "FL",
            "license": "DN12498",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ft. Myers Women'S Health Center, Inc.
• Ft.Myers Dental Services, P.a.
• Jonathan L Fucella, LCSW
• Paul D Fuchs, DO
• Carol Fuechsel
• Adam Fueredi, M.D.
• Jennifer Morton Fugatt, PT
• Shaunte Fulcher
• Megan Renee Fulford
• Billy Ray Fulk, M.D.

• Endodontics in Fort Myers, FL
• Providers in Fort Myers, FL by specialty
• Endodontics in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.