EDISON MALL DENTAL P.A
NPI 1831500404
Dentist in Fort Myers, FL

Q: What is Edison Mall Dental P.A's NPI number?

The NPI number for Edison Mall Dental P.A is 1831500404. It was assigned to this organization in the NPPES registry on May 16, 2014.

Q: What is Edison Mall Dental P.A's specialty?

The primary specialty registered for this NPI is Dentist with taxonomy code 122300000X.

Active since May 16, 2014

4125 CLEVELAND AVE, SUITE 1430, FORT MYERS, FL 33901(954) 846-7171 Get Directions Write a Review

NPPES record last updated: May 16, 2014. Verified against the NPPES registry weekly; last sync: August 16, 2026.

On this page

About Edison Mall Dental P.a NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

EDISON MALL DENTAL P.A (NPI 1831500404) is a healthcare organization registered as a dentist in Fort Myers, Florida and active in the NPI registry since May 2014. The organization lists Rostislav Krasnov, Dds, as its authorized official.

NPPES Registry Identity

NPI1831500404

Entity TypeOrganization

Primary Taxonomy122300000X

Legal Business NameEDISON MALL DENTAL P.A

Location Address4125 CLEVELAND AVE, SUITE 1430Fort Myers, FL 33901-9046

Mailing Address4125 Cleveland Ave, Suite 1430Fort Myers, FL 33901-9046 · (954) 846-7171

Phone(954) 846-7171

Organization SubpartNo

Authorized OfficialRostislav KrasnovDds · (954) 846-7171

Enumeration DateMay 16, 2014

✔ NPI 1831500404 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentistDental Providers

Taxonomy Code122300000X

License✔ Licensed in FL · DN16377

Definition

A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist.

4125 CLEVELAND AVE, Fort Myers, FL 33901

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Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter Health, Ambetter of Alabama, DentaQuest Insurance Company, Inc. and more.Insurance ›

Other Providers at the Same Location NPPES 9

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

IN A BLINK EYE CARE INC

Optometrist

4125 CLEVELAND AVE, SUITE 88
FORT MYERS, FL 33901

Lee County (239) 275-1336

DR. JORDAN MILES KAY O.D.

Optometrist (Corneal and Contact Management)

4125 CLEVELAND AVE, SUITE #113
FORT MYERS, FL 33901

Lee County (239) 939-5393

C&D EYE CARE PA

Optometrist

4125 CLEVELAND AVE, SEARS OPTICAL STE 88
FORT MYERS, FL 33901

Lee County (239) 693-3937

GARRETT SCOTT DENNIS DMD

Dentist (General Practice)

4125 CLEVELAND AVE, SUITE 1430
FORT MYERS, FL 33901

Lee County (239) 939-9050

DR. YOEL RUIZ ORTEGA DMD

Dentist (General Practice)

4125 CLEVELAND AVE
FORT MYERS, FL 33901

Lee County (239) 939-9050

CHARLES CASH INC.

Hearing Aid Equipment

4125 CLEVELAND AVE, SUITE 1415
FORT MYERS, FL 33901

Lee County (239) 936-4656

DR. DONNA JOY MANGATT O.D.

Optometrist

4125 CLEVELAND AVE, SEARS OPTICAL STE 88
FORT MYERS, FL 33901

Lee County (239) 693-3937

IRENA SPIVAK

Dentist

4125 CLEVELAND AVE, SUITE 1430
FORT MYERS, FL 33901

Lee County (239) 939-9050

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Edison Mall Dental P.A's NPI number?

The NPI number for Edison Mall Dental P.A is 1831500404. It was assigned to this organization in the NPPES registry on May 16, 2014.

Where is Edison Mall Dental P.A located?

Edison Mall Dental P.A is located at 4125 Cleveland Ave Suite 1430, Fort Myers, FL 33901. The listed phone number is (954) 846-7171.

What is Edison Mall Dental P.A's specialty?

The primary specialty registered for this NPI is Dentist with taxonomy code 122300000X.

What insurance does Edison Mall Dental P.A accept?

Health plans from Ambetter Health, Ambetter of Alabama, DentaQuest Insurance Company, Inc., Solstice Benefits and UnitedHealthcare list Edison Mall Dental P.A as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Edison Mall Dental P.A was last updated on May 16, 2014. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.