FANTASEA PEDIATRIC DENTISTRY (NPI# 1457874588) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1457874588 |
| Entity Type | Organization |
| Organization Name | FANTASEA PEDIATRIC DENTISTRY |
| Practice Address |
1890 Sw Health Pkwy Ste 104 Naples FL 34109-0473 |
| Practice Telephone | (239) 594-1171 |
| Mailing Telephone | 2395941171 |
| Enumeration Date | 2017-07-20 |
| Last Update Date | 2017-07-20 |
| Authorized Official Name | DR. JOANA LASTRES (OWNER) |
| Authorized Official Telephone | 2395941171 |
| Authorized Official Credential | D.M.D |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223P0221X |
Dentist Specialization: Pediatric Dentistry |
DN21762 | FL | Dental Providers |
| Street Address |
1890 SW HEALTH PKWY STE 104 |
| City | NAPLES |
| State | FL |
| Zip Code | 34109-0473 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407325467 | Dah Therapies LLC | Clinic/Center | 4750 Aston Gardens Way, Therapy Room, Second Floor, Naples, FL 34109 | 2018-11-20 |
| 1003302712 | Ocuflow Doppler LLC | Radiology | 1855 Veterans Park Drive, Naples, FL 34109 | 2018-07-05 |
| 1114417508 | Vascular Center of Naples Inc. | Surgery | 5490 Bryson Dr Ste 201, Naples, FL 34109 | 2018-05-11 |
| 1497257968 | Neuro-tech Inc | Behavioral Analyst | 5687 Naples Blvd Suite A, Naples, FL 34109 | 2018-03-01 |
| 1407302177 | Kendria Brown | Behavioral Analyst | 10641 Airport Pulling Road, Naples, FL 34109 | 2016-08-31 |
| 1255789368 | Ideal Image | Specialist | 1485 Pine Ridge Road Unit #1, Naples, FL 34109 | 2016-05-31 |
| 1790153062 | Lee Memorial Health System | Pharmacy | 3361 Pine Ridge Rd, Suite 100, Naples, FL 34109 | 2015-09-03 |
| 1922400340 | North Naples Pediatric Center | Pediatrics | 9160 Galleria Court, Naples, FL 34109 | 2014-09-17 |
| 1720326978 | Evan Michael Asay | Occupational Therapist | 1865 Veterans Park Drive, Suite 101, Naples, FL 34109 | 2013-01-23 |
| 1942599436 | Anchors Away Medical Corp. | Internal Medicine | 1495 Pine Ridge Rd., Suite 4, Naples, FL 34109 | 2011-04-05 |
| Find all providers in zip 34109 | ||||
| Taxonomy Code | 1223P0221X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Pediatric Dentistry |
| An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578180097 | Juliana Grace Fitzgerald | Dentist | 7505 Grand Lely Dr Bldg 1, Naples, FL 34113-1753 | 2020-06-30 |
| 1558915157 | Dentistry for Children of Florida, Pllc | Dentist | 3021 Airport Rd N Ste 203, Naples, FL 34105-3077 | 2019-07-31 |
| 1396227278 | Hakuna Matata Pediatric Dentistry of Naples,pa | Dentist | 2544 Northbrooke Plaza Dr Ste 4, Naples, FL 34119-7960 | 2018-09-06 |
| 1710408455 | Michelle Lee Thomas | Dentist | 1879 Veterans Park Dr Ste 1203, Naples, FL 34109-0500 | 2017-07-03 |
| 1306268172 | Marilyn Claire Sandor | Dentist | 4529 Executive Dr Ste 101, Naples, FL 34119-9032 | 2014-01-14 |
| 1174614465 | Lauren M Governale | Dentist | 7007 Lely Cultural Pkwy, Naples, FL 34113-8976 | 2006-09-28 |
| 1063527828 | Kelly Magher | Dentist | 7505 Grand Lely Dr Bldg L, Naples, FL 34113-1753 | 2006-08-20 |
| 1851348585 | Gerardo Santiago | Dentist | 3699 Airport Rd N, Naples, FL 34105-8516 | 2006-05-28 |
| 1205453768 | Phillip Scott Dodson | Dentist | 7505 Grand Lely Dr, Naples, FL 34113-1753 | 2020-07-01 |
| 1790302214 | Linda Lavadia | Dentist | 7505 Grand Lely Dr, Naples, FL 34113-1753 | 2020-06-30 |
| Find all providers in NAPLES | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.