Gregory Quattlebaum Jr., DMD

Primary specialty

DentistTaxonomy code 122300000X

License

24422 Issued in FL

Practice address

4953 Castello Dr
Naples, FL 34103-8927

Phone

(239) 263-2122

NPI assigned

Apr 14, 2019

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Boe, Page & Page Dental Group PLLC

  • Dentist
  • Naples, FL
  • NPI 1013357847
  NPD (past)
• Steven Boe DMD & Stephen Page DMD, PA

  • General Practice Dentistry
  • Naples, FL
  • NPI 1073637336
  NPD (past)

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

{
    "created_epoch": "1555200000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628640000000",
    "number": "1902469133",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4953 CASTELLO DR",
            "city": "NAPLES",
            "state": "FL",
            "postal_code": "341038927",
            "telephone_number": "239-263-2122"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4953 CASTELLO DR",
            "city": "NAPLES",
            "state": "FL",
            "postal_code": "341038927",
            "telephone_number": "239-263-2122"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "111 E 210th St",
            "address_purpose": "LOCATION",
            "city": "Bronx",
            "state": "NY",
            "postal_code": "104672401",
            "country_code": "US",
            "telephone_number": "561-309-4332",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "151 Cortez Rd",
            "address_purpose": "LOCATION",
            "city": "West Palm Beach",
            "state": "FL",
            "postal_code": "334054103",
            "country_code": "US",
            "telephone_number": "561-309-4332",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "QUATTLEBAUM",
        "first_name": "GREGORY",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-04-14",
        "last_updated": "2021-08-11",
        "certification_date": "2021-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NY",
            "license": null,
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "24422",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Quality Pain Rehab LLC
• Jarrod William Qualk, PHARMD
• Lindsey Ann Qualk, PHARM.D.
• Quantum Orthotics & Brace LLC
• Alvina Mary Quatrano, L.M.T.
• Queanh Phan DMD PLLC (Fantastic Dental Arts)
• Thalia Maria Querol Delgado
• Luigi Querusio, MD
• Mary Elizabeth Quick, MA, LMHC
• Francisco J Quiles-Cruz, M.D.

• Dentist in Naples, FL
• Providers in Naples, FL by specialty
• Dentist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 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.

Verify at the official NPI Registry.