FAIRWATER DENTAL GROUP
NPI 1386922235
Dentist - General Practice in Orlando, FL

Active since July 26, 2011
1221 W FAIRBANKS AVE, ORLANDO, FL 32804(407) 628-9091(407) 256-4040 Get Directions Write a Review

NPPES record last updated: July 26, 2011. Verified against the NPPES registry weekly; last sync: July 19, 2026.

  • Organization
  • Dentist
  • General Practice

About FAIRWATER DENTAL GROUP

This page provides the complete NPI Profile along with additional information for Fairwater Dental Group, a provider established in Orlando, Florida operating as a Dentist, focusing in general practice . The healthcare provider is registered in the NPI registry with number 1386922235 assigned on July 2011. The practitioner's primary taxonomy code is 1223G0001X. The provider is registered as an organization and their NPI record was last updated 15 years ago. The organization operates as a Single Specialty Group with one or more individual practitioners, all of who practice with the same area of specialization. The provider's is doing business as Fairwater Dental Group. The authorized official of this NPI record is Pam Hardiek (Insurance/credentialing)

NPI
1386922235 Verify this NPI
Provider Legal Name
COMFORTABLE CARE DENTAL HEALTH PROFESSIONALS, PA
Other Organization Name
FAIRWATER DENTAL GROUP
Other Name Type
Doing Business As (3)
Entity Type
Organization
Location Address
1221 W FAIRBANKS AVE ORLANDO, FL 32804
Location Phone
(407) 628-9091
Location Fax
(407) 256-4040
Mailing Address
1221 W FAIRBANKS AVE ORLANDO, FL 32804
Mailing Phone
(407) 628-9091
Mailing Fax
(407) 256-4040
Is Sole Proprietor?
No
Is Organization Subpart?
Yes
Enumeration Date
07-26-2011
Last Update Date
07-26-2011
Code Navigator

A dentist like Fairwater Dental Group is a skilled in and licensed provider that diagnoses and treats problems with patients teeth, gums, and related parts of the mouth. Dentists educate patients on how to take care of the teeth and gums and provide information on diet choices that affect oral health. Dentists must be licensed in the state in which they work.

Location Map

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Dentist General Practice

Taxonomy Code
1223G0001X
Type
Dental Providers
Taxonomy Description
A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.

Group Taxonomy 193400000X SINGLE SPECIALTY GROUP

This provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

PAM HARDIEK

Authorized Official Title
INSURANCE/CREDENTIALING
Authorized Official Phone
(217) 540-5100

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Other Providers at the Same Location


The following 3 providers are registered at the same or a nearby location.

Dentist (General Practice)
1221 W FAIRBANKS AVE
ORLANDO, FL 32804
Dentist
1221 W FAIRBANKS AVE
ORLANDO, FL 32804
Clinic/Center (Dental)
1221 W FAIRBANKS AVE
ORLANDO, FL 32804

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1386922235, enumerated as an "organization" on July 26, 2011.

The provider is located at 1221 W FAIRBANKS AVE ORLANDO, FL 32804 and the phone number is (407) 628-9091.

Dentist with taxonomy code 1223G0001X and a focus in General Practice.