Healthcare Provider Details

I. General information

NPI: 1699601302
Provider Name (Legal Business Name): SASHA JOSEPH DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/22/2026
Last Update Date: 06/22/2026
Certification Date: 06/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4757 MIRAGE BAY CIR UNIT 401
FORT MYERS FL
33966-6639
US

IV. Provider business mailing address

4757 MIRAGE BAY CIR UNIT 401
FORT MYERS FL
33966-6639
US

V. Phone/Fax

Practice location:
  • Phone: 407-462-5844
  • Fax:
Mailing address:
  • Phone: 407-462-5844
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QF0400X
TaxonomyFederally Qualified Health Center (FQHC)
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: