Healthcare Provider Details

I. General information

NPI: 1063348274
Provider Name (Legal Business Name): NOAH NALEWAJA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/23/2026
Last Update Date: 06/23/2026
Certification Date: 06/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19521 HIGHLAND OAKS DR STE 301
ESTERO FL
33928-9634
US

IV. Provider business mailing address

10900 LEGACY GATEWAY CIR UNIT 412
FORT MYERS FL
33913-2652
US

V. Phone/Fax

Practice location:
  • Phone: 239-244-8853
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberDN32027
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: