OrganizationActive
Edison Mall Dental P.A
NPI 1831500404 · Dentist · Fort Myers, FL
Edison Mall Dental P.A is a Dentist organization in Fort Myers, FL (NPI 1831500404).
Provider details
- NPI number
- 1831500404
- Entity type
- Organization
- Primary specialty
- DentistDental Providers
- Organization subpart
- No
- Authorized official
- Rostislav Krasnov, DDS(954) 846-7171
- License
- DN16377 (FL)
Specialties & taxonomies
Dental Providers
Profile Score
Detailed profile(76/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
12 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
4125 Cleveland Ave
Suite 1430
Fort Myers, FL 33901-9046
Phone: (954) 846-7171
Street-level locationGet directions
Mailing address
4125 Cleveland Ave
Fort Myers, FL 33901-9046
Registry dates
- Enumerated
- 2014-05-16
- Last updated
- 2014-05-16
Frequently asked questions
- What is Edison Mall Dental P.A's NPI number?
- Edison Mall Dental P.A's National Provider Identifier (NPI) is 1831500404, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Edison Mall Dental P.A?
- Edison Mall Dental P.A is classified in the NPPES registry as Dentist (Dental Providers).
- Where is Edison Mall Dental P.A located?
- Edison Mall Dental P.A's practice location on file with NPPES is 4125 Cleveland Ave, Fort Myers, FL 33901-9046.
- What is Edison Mall Dental P.A's phone number?
- The practice phone number listed in the NPPES registry for Edison Mall Dental P.A is (954) 846-7171.
- Who is the authorized official for Edison Mall Dental P.A?
- The authorized official listed on Edison Mall Dental P.A's NPPES record is Rostislav Krasnov, DDS. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Edison Mall Dental P.A's NPI active?
- Yes — Edison Mall Dental P.A's NPI (1831500404) is active in the NPPES registry as of the last update on 2014-05-16.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.