Healthcare Provider Details

I. General information

NPI: 1770162067
Provider Name (Legal Business Name): DR. NICOLETTA ROSSANA VENTURINI
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/05/2021
Last Update Date: 08/03/2026
Certification Date: 08/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8201 MARKET ST
WILMINGTON NC
28411-9389
US

IV. Provider business mailing address

22911 LYDEN DR STE B
ESTERO FL
33928-7046
US

V. Phone/Fax

Practice location:
  • Phone: 910-550-1853
  • Fax:
Mailing address:
  • Phone: 239-312-3132
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License Number0214
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number26227
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: