Individual provider Active NPI

Anissa Ahmadi, D.M.D.

  • Pediatric Dentistry
  • Fort Myers, FL
National Provider Identifier
1912045147
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
DN16262 Issued in FL
Practice address
45 Barkley Cir
Fort Myers, FL 33907-7531
Phone
(239) 939-0423
Fax
(239) 939-4912
NPI assigned
Feb 1, 2007
Sex
Female
Sole proprietor
No

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
Pediatric Dentistry 1223P0221X DN16262 FL Primary

Addresses

Primary practice location

45 Barkley Cir
Fort Myers, FL 33907-7531

Mailing address

45 Barkley Cir
Fort Myers, FL 33907-7531
Phone (239) 939-0423

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

LicenseStateTypeSpecialty
DN16262FLMDPediatric Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
Barkley Circle Dental Center Pediatric Dentistry Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1170288000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1912045147",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "45 BARKLEY CIR",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339077531",
            "telephone_number": "239-939-0423",
            "fax_number": "239-939-4912"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "45 BARKLEY CIR",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339077531",
            "telephone_number": "239-939-0423",
            "fax_number": "239-939-4912"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AHMADI",
        "first_name": "ANISSA",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "FL",
            "license": "DN16262",
            "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.