Basista & Eldridge DDS PA

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

BASISTA & ELDRIDGE DDS PA

Practice address

2454 Winkler Ave
Fort Myers, FL 33901

Phone

(239) 936-3866

Fax

(239) 939-5098

NPI assigned

Nov 14, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Michael John Basista, DDSNPI 1780944629

Title

President Treasurer

Phone

(239) 936-3866

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Michael John Basista, D.D.S.

  • Dentist
  • Fort Myers, FL
  • NPI 1780944629
  NPD (past) Authorized official

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

{
    "created_epoch": "1163462400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1881766392",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2454 WINKLER AVE",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "33901",
            "telephone_number": "239-936-3866",
            "fax_number": "239-939-5098"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2454 WINKLER AVE",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "33901",
            "telephone_number": "239-936-3866",
            "fax_number": "239-939-5098"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BASISTA & ELDRIDGE DDS PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-14",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BASISTA",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "JOHN",
        "authorized_official_title_or_position": "PRESIDENT TREASURER",
        "authorized_official_telephone_number": "239-936-3866",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sally Barth, DDS
• Keesha Alexandra Barthelemy, LMHC, CASAC-2
• Shannon Bartz, PHARMD
• Heather Barzo, APRN
• Deborah Tafoya Basford, CM
• Michael John Basista, D.D.S.
• Syeda Sumara Taranum Basith, M.D.
• Lesjuantavius Najiik Baskin, RPT
• Ivette Basora
• Nicole Basora

• General Practice Dentistry in Fort Myers, FL
• Providers in Fort Myers, FL by specialty
• General Practice Dentistry in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.