NPIMap

Organization Active NPI

Midpoint Dentistry

Doing business as Lakes Park Children's Dentistry & Orthodontics

  • Pediatric Dentistry
  • Fort Myers, FL
National Provider Identifier
1841625910
Registry record updated Sep 9, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
DN13738 Issued in FL
Legal business name
MIDPOINT DENTISTRY
Doing business as
Lakes Park Children's Dentistry & Orthodontics
Practice address
7117 Congdon Rd
Suite 100
Fort Myers, FL 33908-4216
Phone
(239) 418-1444
Fax
(239) 418-1888
NPI assigned
Sep 9, 2013
Last updated
Sep 9, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 9, 2013

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

Authorized official

Name
Dr. Oliver P FavalliNPI 1598874752
Title
Owner/Doctor
Phone
(239) 418-1444

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Dentistry 1223P0221X DN13738 FL Primary

Addresses

Primary practice location

7117 Congdon Rd
Suite 100
Fort Myers, FL 33908-4216

Mailing address

7117 Congdon Rd
Suite 100
Fort Myers, FL 33908-4216
Phone (239) 418-1444

Other identifiers 1

IdentifierTypeStateIssuer
070912300MedicaidFL

Other names 1

  • Lakes Park Children's Dentistry & Orthodontics Doing business as

National Provider Directory

National Provider Directory

Locations

7117 Congdon Rd
Apt 100
Fort Myers, FL 33908
Phone (239) 418-1444

Practitioners & affiliated clinicians

Practitioners 2

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": "1378684800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1378684800000",
    "number": "1841625910",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7117 CONGDON RD",
            "address_2": "SUITE 100",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339084216",
            "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": "7117 CONGDON RD",
            "address_2": "SUITE 100",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339084216",
            "telephone_number": "239-418-1444",
            "fax_number": "239-418-1888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIDPOINT DENTISTRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-09-09",
        "last_updated": "2013-09-09",
        "status": "A",
        "authorized_official_last_name": "FAVALLI",
        "authorized_official_first_name": "OLIVER",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "OWNER/DOCTOR",
        "authorized_official_telephone_number": "239-418-1444",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "FL",
            "license": "DN13738",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "070912300",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lakes Park Children's Dentistry & Orthodontics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fort Myers, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2013; 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.