Active NPI
John W Valentine, DMD
- General Practice Dentistry
- Naples, FL
National Provider Identifier
1881925667
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- DN14676
- Practice address
- 12692 Tamiami TRL E
Naples, FL 34113-8431 - Phone
- (239) 417-6453
- Fax
- (239) 775-6628
- NPI assigned
- Jan 19, 2010
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | DN0014676 | FL | |
| General Practice Dentistry | 1223G0001X | DN14676 | FL | Primary |
Addresses
Primary practice location
12692 Tamiami TRL E
Naples, FL 34113-8431
Mailing address
12692 Tamiami TRL E
Naples, FL 34113-8431
Phone (239) 417-6453
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DN0014676 | FL | MD | Dentist |
| DN14676 | FL | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Eagle Creek Dentistry, Inc. | Dentist | Current | Accepting new patients |
| Smile Design Eagle Creek LLC | General Practice | Past | Accepting new patients |
Locations
12692 Tamiami Trl E
Naples, FL 34113
Phone (239) 417-6453
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Dentist
- Naples, FL
- NPI 1639391725
-
- General Practice Dentistry
- Naples, FL
- NPI 1265388987
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1263859200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1617840000000",
"number": "1881925667",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12692 TAMIAMI TRL E",
"city": "NAPLES",
"state": "FL",
"postal_code": "341138431",
"telephone_number": "239-417-6453",
"fax_number": "239-775-6628"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12692 TAMIAMI TRL E",
"city": "NAPLES",
"state": "FL",
"postal_code": "341138431",
"telephone_number": "239-417-6453",
"fax_number": "239-775-6628"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VALENTINE",
"first_name": "JOHN",
"middle_name": "W",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2010-01-19",
"last_updated": "2021-04-08",
"certification_date": "2021-04-08",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "FL",
"license": "DN0014676",
"primary": false
},
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "FL",
"license": "DN14676",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Naples, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.