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 provides 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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