MEDICARE: DR. DEIRDRE M CAMPBELL DMD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	DN16533	FL

General Provider Information

NPI Number	:	1750475398
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DEIRDRE M CAMPBELL DMD

Provider Business Mailing Address
First Line	:	4447 CAMINO REAL WAY
Second Line	:
City	:	FORT MYERS
State	:	FL
Zip	:	33966
Country	:	US
Telephone Number	:	239-936-7400
Fax Number	:

Provider Business Practice Location Address
First Line	:	4447 CAMINO REAL WAY
Second Line	:
City	:	FORT MYERS
State	:	FL
Zip	:	33966
Country	:	US
Telephone Number	:	239-936-7400
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/03/2006
Last Update Date	:	02/20/2026

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