Picasso Aesthetic and Cosmetic Dental Spa PA

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

Legal business name

PICASSO AESTHETIC AND COSMETIC DENTAL SPA PA

Practice address

3660 Central Ave Ste 14
Fort Myers, FL 33901-8258

Phone

(239) 401-2799

Fax

(239) 320-3288

NPI assigned

Jul 27, 2012

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Jeffrey RubinNPI 1073520789

Title

President

Phone

(239) 370-3343

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jeffrey E Rubin

  • Oral and Maxillofacial Surgery (Dentist)
  • Fort Myers, FL
  • NPI 1073520789
  Medicare reassignment NPD Authorized official
• Shannon Elizabeth Novak, D.M.D.

  • General Practice Dentistry
  • Naples, FL
  • NPI 1871904581
  NPD (past)

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

{
    "created_epoch": "1343347200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1772668800000",
    "number": "1205182276",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20843 THISTLE LEAF LN",
            "city": "ESTERO",
            "state": "FL",
            "postal_code": "339284082",
            "telephone_number": "239-401-2799",
            "fax_number": "239-320-3288"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3660 CENTRAL AVE STE 14",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339018258",
            "telephone_number": "239-401-2799",
            "fax_number": "239-320-3288"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PICASSO AESTHETIC AND COSMETIC DENTAL SPA PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-07-27",
        "last_updated": "2026-03-05",
        "certification_date": "2026-03-05",
        "status": "A",
        "authorized_official_last_name": "RUBIN",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "239-370-3343"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN12852",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "070759700",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Physicians Wellness Associates
• Physicians' Primary Care of Southwest Florida, P.L.
• Physiotherapy Associates Inc
• James Richard Piano, DDS
• Avery Ryann Piatt
• Albania Pichardo
• Dawn Marie Picotte, MD
• Jennifer Picou, BA, BCABA
• William Henry Pierce III, LPTA
• Zoe Pierce

• Oral and Maxillofacial Surgery (Dentist) in Fort Myers, FL
• Providers in Fort Myers, FL by specialty
• Oral and Maxillofacial Surgery (Dentist) in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.