Organization Active NPI

Friendly Dental PA

  • Dentist
  • Estero, FL
National Provider Identifier
1780342733
Registry record updated Dec 13, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
FRIENDLY DENTAL PA
Practice address
23100 Via Villagio
Estero, FL 33928-8301
Phone
(239) 529-4159
NPI assigned
Dec 7, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 13, 2021

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

Authorized official

Name
Robin Mamo
Title
Office Manager
Phone
(239) 529-4159

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 122300000X Primary

Addresses

Primary practice location

23100 Via Villagio
Estero, FL 33928-8301

Mailing address

16520 S Tamiami TRL Ste 106
Fort Myers, FL 33908-5319
Phone (239) 529-4159

Other practice location 1

16520 S Tamiami Trl Ste 106
Fort Myers, FL 33908-5319
Phone (239) 529-4159

National Provider Directory

National Provider Directory

Locations

23100 Via Villagio
Estero, FL 33928
Phone (239) 529-4159

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1638835200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1639353600000",
    "number": "1780342733",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16520 S TAMIAMI TRL STE 106",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339085319",
            "telephone_number": "239-529-4159"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23100 VIA VILLAGIO",
            "city": "ESTERO",
            "state": "FL",
            "postal_code": "339288301",
            "telephone_number": "239-529-4159"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "16520 S Tamiami Trl Ste 106",
            "address_purpose": "LOCATION",
            "city": "Fort Myers",
            "state": "FL",
            "postal_code": "339085319",
            "country_code": "US",
            "telephone_number": "239-529-4159",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "FRIENDLY DENTAL PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-12-07",
        "last_updated": "2021-12-13",
        "certification_date": "2021-12-13",
        "status": "A",
        "authorized_official_last_name": "MAMO",
        "authorized_official_first_name": "ROBIN",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "239-529-4159"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Estero, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2021; 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.