Main Street Children's Dentistry and Orthodontics of Ft. Myers, P.A.
NPI 1962794602ActiveOrganization· Dentist, Pediatric Dentistry· Fort Myers, FL
Dentist, Pediatric Dentistry in Fort Myers, Florida, registered in NPPES in May 2011. The authorized official on file is Stephanie Gomez, Provider Relations Specialist.
Overview
| NPI | 1962794602 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | May 13, 2011 |
| Last updated in NPPES | Aug 1, 2014 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Dentist, Pediatric Dentistry Primary | 1223P0221X | — | — |
| Dentist | 122300000X | — | — |
| Dentist, Orthodontics and Dentofacial Orthopedics | 1223X0400X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Not in the public enrollment file of Oct 1, 2026 |
|---|
Other pediatric dentists in Fort Myers
- 1013981620
- 1023561826
- 1033892021
- 1043665227
- 1043925316
- 1437479169
- 1457791238
- 1497893630
- 1598874752
- 1710130661
- 1841625910
- 1982296240
All 18 pediatric dentists in Fort Myers · All pediatric dentists in Florida