The year this clinician's National Provider Identifier (NPI) was issued. An NPI is a unique 10-digit ID that US health care providers use for billing.

What this does not show

NPIs have been issued only since 2005, so this year is not necessarily when the clinician started practicing.

Source: CMS NPPES NPI Registry.

Medicare assignment not listed

CMS data do not show whether this clinician accepts Medicare assignment. This does not mean they do not accept Medicare. Ask the office.

Medicare assignment applies to Original Medicare. It does not tell you whether the clinician is in a Medicare Advantage plan's network, accepts other insurance, or is taking new patients.

Source: CMS Doctors and Clinicians; Medicare.gov, “Does your provider accept Medicare as full payment?”

Guide: What Medicare assignment means

No telehealth indicator

CMS shows this indicator only when recent Medicare claims include telehealth services. The clinician may still offer telehealth; ask the office.

Source: CMS, Telehealth Indicator on Medicare Care Compare (fact sheet, January 2023); CMS Doctors and Clinicians.

Guide: How Medicare covers telehealth

Compared with the same specialty in Estero and Florida

14 active clinicians are listed under Dentist with a practice address in Estero, FL (6,164 in Florida).

Addresses are self-reported to NPPES and may be out of date.

Telehealth indicator in Estero

0% of these 14 clinicians have the CMS telehealth indicator.

0% of these 14 clinicians are listed by CMS as accepting Medicare assignment.

Sources: CMS Doctors and Clinicians, CMS NPPES NPI Registry. Specialty names follow the NUCC Health Care Provider Taxonomy.

Text: T-MedInfo · Report an error.

Specialties & License Numbers Reported to NPPES

Self-certified to NPPES: 2026-08-03

Dentist Primary Specialty

NUCC Taxonomy Code: 122300000X

License # reported to NPPES FL DN30771

A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist.

Check License Status with the State Board License numbers are self-reported to NPPES; T-MedInfo does not confirm them against state records. Current status: Florida Department of Health Medical Quality Assurance.

Look Up on State Board Site

Clinicians Sharing This Practice Address or Phone

Clinicians sharing this NPPES address, phone or fax; a shared contact does not mean they work together.

1 listed

Dr. Lawrence Wallen , DC

Chiropractor

NPI 1295050516

Doctor of Chiropractic

Career & Practice History Timeline

Changes recorded in monthly NPPES data files: addresses, names, credentials, specialties and NPI status

9 Historical Events

📍

Updated Practice Location August 03, 2026

Registered at 21740 S TAMIAMI TRL, ESTERO, FL 339282819 (Tel: 2392362130)

📍

Updated Business Mailing Address August 03, 2026

Registered at 3925 NE 23RD AVE, CAPE CORAL, FL 339093437 (Tel: 8134006742)

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) August 03, 2026

Dentist (license number reported to NPPES: FL DN30771)

✅

NPI Profile Active May 01, 2023

NPI status registered as active in NPPES database

📍

Practice Location (Initial Record) May 01, 2023

Registered at 2920 N 4TH ST, FLAGSTAFF, AZ 860041816 (Tel: 9285229400)

📍

Business Mailing Address (Initial Record) May 01, 2023

Registered at 7520 OMNI LN APT 301, FORT MYERS, FL 339055477 (Tel: 8134006742)

👤

Provider Name / Credentials (Initial Record) May 01, 2023

Recorded as IVAN VIGOA

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) May 01, 2023

Student in an Organized Health Care Education/Training Program

🟢

Initial NPI Registration & Enumeration May 01, 2023

First registered as active Individual Practitioner in NPPES Database.

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NPI Administrative Meta

NPI Number: 1104514827

Entity Type:

Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)

Enumeration Date: May 01, 2023

Last Update: August 03, 2026

Sole Proprietor: Yes

Update or Correct Profile

Other Dentists in Estero

All Dentists in Estero

Mailing Address

3925 Ne 23rd Ave

Cape Coral, FL 339093437

Phone: 8134006742

About This Data NPPES fields (address, phone, specialty, license) are self-reported and may be outdated; Medicare fields follow the CMS dataset named in each section. Correct directly at NPPES.