Bonita Springs Edc Management LLC
NPI 1205304375ActiveOrganization· Dentist, General Practice· Tampa, FL
Dentist, General Practice in Tampa, Florida, registered in NPPES in November 2018, part of Bonita Springs Edc Management LLC. The authorized official on file is Michael Obeng, Manager.
Overview
| NPI | 1205304375 |
|---|---|
| Status | Active |
| Entity type | Organization (subpart) |
| Parent organization | Bonita Springs Edc Management LLC |
| NPI issued | Nov 7, 2018 |
| Last updated in NPPES | Aug 3, 2023 |
| Certified by provider | Aug 3, 2023 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Dentist, General Practice Primary | 1223G0001X | — | — |
| Clinic/Center, Dental | 261QD0000X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Not in the public enrollment file of Oct 1, 2026 |
|---|
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