Pediatric Dentistry & Interceptive Orthodontics P.C.

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

050957 Issued in NY

Legal business name

PEDIATRIC DENTISTRY & INTERCEPTIVE ORTHODONTICS P.C.

Practice address

8016 E Genesee St
Fayetteville, NY 13066-9692

Phone

(315) 637-6961

Fax

(315) 637-0169

NPI assigned

Dec 11, 2006

Last updated

Sep 11, 2025By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Edward Robison, D.D.S.NPI 1639291321

Title

Treasurer

Phone

(315) 637-6961

Specialties & licenses 4

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Edward Robison, D.D.S.

  • Pediatric Dentistry
  • Fayetteville, NY
  • NPI 1639291321
  Authorized official Same address or phone

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

{
    "created_epoch": "1165795200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757548800000",
    "number": "1346300209",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8016 E GENESEE ST",
            "city": "FAYETTEVILLE",
            "state": "NY",
            "postal_code": "130669692",
            "telephone_number": "315-637-6961",
            "fax_number": "315-637-0169"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8016 E GENESEE ST",
            "city": "FAYETTEVILLE",
            "state": "NY",
            "postal_code": "130669692",
            "telephone_number": "315-637-6961",
            "fax_number": "315-637-0169"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRIC DENTISTRY & INTERCEPTIVE ORTHODONTICS P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-11",
        "last_updated": "2025-09-11",
        "status": "A",
        "authorized_official_last_name": "ROBISON",
        "authorized_official_first_name": "EDWARD",
        "authorized_official_title_or_position": "TREASURER",
        "authorized_official_telephone_number": "315-637-6961",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "NY",
            "license": "027300",
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "NY",
            "license": "043434",
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "NY",
            "license": "038405",
            "primary": false
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "NY",
            "license": "050957",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tamra A. Parker, LCSW-R
• Priya Prakash Patel, PA
• Paula Pons Physician LLC
• Nicolas Pauly, NPP
• Samuel B Pearlstein, DPM
• Joseph G Perry, D.D.S
• Shannon Phan
• Joyce Ann Phillips, L.M.T.
• Matthew Lee Picone, MD.
• Playful Pathways Occupational Therapy PLLC

• Orthodontics and Dentofacial Orthopedics Dentistry in Fayetteville, NY
• Providers in Fayetteville, NY by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.