Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of October 4, 2026.
NPIDirectory

Fayetteville Family Dentistry

Organization Dentist · NPI 1831790500

Fayetteville Family Dentistry provides Dentist services in Fayetteville, New York. Registered with an NPI since 2020.

In the registry since
2020
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Practice location Address checks out

6962 Highbridge Rd
Fayetteville, NY 13066-9705
Phone: (315) 373-0869
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Dentist (primary) Taxonomy 122300000X

Record details

NPI number1831790500
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Imadeh Nosegbe — Owner · (315) 373-0869
NPI enumeratedNovember 8, 2020
Last updated in NPPESNovember 8, 2020
Certification dateNovember 8, 2020
Mailing address6962 Highbridge Rd, Fayetteville, NY 13066-9705

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