Individual provider Active NPI

Heather Althea Adu-Sarkodie, DDS, PHD

  • Endodontics
  • Fort Myers, FL
National Provider Identifier
1891866687
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
EndodonticsTaxonomy code 1223E0200X
License
DN16645 Issued in FL
Practice address
12711 McGregor Blvd
Fort Myers, FL 33919-4412
Phone
(239) 728-3636
Fax
(239) 693-3637
NPI assigned
Nov 13, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endodontics 1223E0200X DN16645 FL Primary

Addresses

Primary practice location

12711 McGregor Blvd
Fort Myers, FL 33919-4412

Mailing address

12711 McGregor Blvd
Fort Myers, FL 33919-4412
Phone (239) 728-3636

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
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
DN16645FLMDEndodontist

NPI Registry JSON

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

{
    "created_epoch": "1163376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1891866687",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12711 MCGREGOR BLVD",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339194412",
            "telephone_number": "239-728-3636",
            "fax_number": "239-693-3637"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12711 MCGREGOR BLVD",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339194412",
            "telephone_number": "239-728-3636",
            "fax_number": "239-693-3637"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ADU-SARKODIE",
        "first_name": "HEATHER",
        "middle_name": "ALTHEA",
        "name_prefix": "Dr.",
        "credential": "DDS, PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-13",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "FL",
            "license": "DN16645",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Myers, FL

Sources for this page

  • 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.