Oliver Peter Favalli

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

13738 Issued in FL

Practice address

5150 Mason Corbin CT
Suite #2
Fort Myers, FL 33907

Phone

(239) 418-1444

NPI assigned

Aug 30, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Midpoint Dentistry

  • Pediatric Dentistry
  • Fort Myers, FL
  • NPI 1841625910
  NPD (past) Authorized official

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1464134400000",
    "number": "1598874752",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7117 CONGDON ROAD",
            "address_2": "SUITE 100",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "33908",
            "telephone_number": "239-418-1444",
            "fax_number": "239-418-1888"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5150 MASON CORBIN CT",
            "address_2": "SUITE #2",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "33907",
            "telephone_number": "239-418-1444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAVALLI",
        "first_name": "OLIVER",
        "middle_name": "PETER",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-30",
        "last_updated": "2016-05-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "FL",
            "license": "13738",
            "primary": true
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "FL",
            "license": "13738",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Whitney Fast, RBT
• Ahmad Reza Fatemi-Sadr, M.ED
• Courtney August Faunce, RMHCI
• Wesley H Faunce III, M.D.
• Claudine Giselle Faure
• Elinda Marie Favaloro, COTA
• Antonino Favia
• Tod Richard Fawcett
• Margaret Fay, ARNP
• Islam Ibrahim Fayed, DO

• Pediatric Dentistry in Fort Myers, FL
• Providers in Fort Myers, FL by specialty
• Pediatric Dentistry in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 2016; 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.