Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Pediatric Dentistry & Interceptive Orthodontics PC

Organization Pediatric Dentistry · NPI 1346300209

Pediatric Dentistry & Interceptive Orthodontics PC is a Pediatric Dentistry in Fayetteville, New York. Licensed in New York. Registered with an NPI since 2006.

Licensed in
NY
In the registry since
2006
Specialties on file
4
What do these letters mean?
PC — Professional corporation
A form of business registration, not a clinical qualification.

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Practice location Address checks out

8016 E Genesee St
Fayetteville, NY 13066-9692
Phone: (315) 637-6961
Fax: (315) 637-0169
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Orthodontics and Dentofacial Orthopedics Dentistry (primary) Taxonomy 1223X0400X · Licence 050957 (NY)
Pediatric Dentistry Taxonomy 1223P0221X · Licence 027300 (NY)
Pediatric Dentistry Taxonomy 1223P0221X · Licence 043434 (NY)
Pediatric Dentistry Taxonomy 1223P0221X · Licence 038405 (NY)

Record details

NPI number1346300209
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Edward Robison — Treasurer · (315) 637-6961
NPI enumeratedDecember 11, 2006
Last updated in NPPESSeptember 11, 2025
Mailing address8016 E Genesee St, Fayetteville, NY 13066-9692

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