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DR. BROCK REICHARDT DDS
NPI 1356025209
Dentist - General Practice in Port Charlotte, FL

Active since June 12, 2023Opted out of Medicare · through Mar 19, 2028
941 TAMIAMI TRL STE F, PORT CHARLOTTE, FL 33953(402) 604-0663 Get Directions Write a Review

NPPES record last updated: June 12, 2023. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Dr. Brock Reichardt Dds NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. BROCK REICHARDT DDS (NPI 1356025209) is an individual general practice provider in Port Charlotte, Florida, licensed in Florida (27919) and active in the NPI registry since June 2023. He has opted out of Medicare through March 19, 2028.

NPPES Registry Identity

NPI1356025209
Entity TypeIndividualMale
Primary Taxonomy1223G0001X
Provider Legal NameDR. BROCK REICHARDTCredential: DDS
Location Address941 TAMIAMI TRL STE FPort Charlotte, FL 33953-3121
Mailing Address941 Tamiami Trl Ste FPort Charlotte, FL 33953-3121 · (402) 604-0663
Phone(402) 604-0663
Sole ProprietorNo
Enumeration DateJune 12, 2023
NPPES CertifiedJune 12, 2023
✔ NPI 1356025209 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · General PracticeDental Providers
Taxonomy Code1223G0001X
License✔ Licensed in FL · 27919
Definition
A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.
941 TAMIAMI TRL STE F, Port Charlotte, FL 33953
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Dr. Brock Reichardt Dds has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from March 19, 2024 through March 19, 2028.

Opt-Out Effective DateMarch 19, 2024
Opt-Out In Effect ThroughMarch 19, 2028Opt-out affidavits renew automatically every two years unless cancelled

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

OLIVER GUILLERMO CABRERA DDS
Dentist
941 TAMIAMI TRL STE F
PORT CHARLOTTE, FL 33953
Charlotte County (941) 629-7779
SOUL DENTAL PLLC
Dentist (General Practice)
941 TAMIAMI TRL STE F
PORT CHARLOTTE, FL 33953
Charlotte County (941) 629-7779

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Brock Reichardt's NPI number?

The NPI number for Brock Reichardt is 1356025209. It was assigned to this individual provider in the NPPES registry on June 12, 2023.

Where is Brock Reichardt located?

Brock Reichardt practices at 941 Tamiami Trl Ste F, Port Charlotte, FL 33953. The listed phone number is (402) 604-0663.

What is Brock Reichardt's specialty?

The primary specialty registered for this NPI is Dentist, specializing in General Practice, with taxonomy code 1223G0001X.

Is Brock Reichardt enrolled in Medicare?

No. Brock Reichardt has opted out of Medicare through March 19, 2028. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out.

When was this NPI record last updated?

The NPPES record for Brock Reichardt was last updated on June 12, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.