Paul Clark Fawson III, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DE60291946 Issued in WA

Practice address

2204 E 29H Ave
Suite 208
Spokane, WA 99203-3961

Phone

(509) 535-9515

Fax

(509) 535-9525

NPI assigned

May 12, 2011

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1305158400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1366675200000",
    "number": "1003108820",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2204 E 29H AVE",
            "address_2": "SUITE 208",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992033961",
            "telephone_number": "509-535-9515",
            "fax_number": "509-535-9525"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2204 E 29H AVE",
            "address_2": "SUITE 208",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992033961",
            "telephone_number": "509-535-9515",
            "fax_number": "509-535-9525"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAWSON",
        "first_name": "PAUL",
        "middle_name": "CLARK",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-05-12",
        "last_updated": "2013-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MT",
            "license": "2458",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WA",
            "license": "DE60291946",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Aaron Samuel Fauth
• Kassidy Lynn Favaro
• Michael David Favero, MD
• Gabriella Favorito
• Paul C Fawcett, MS, OTR/L
• Aaron Charles Fay, RN
• Alexondria Elizabeth Fay
• Kyle Joseph Fay, PHARMD
• Michael J Fay, PAC
• Jaime Lynn Fazzone, PHARMD

• General Practice Dentistry in Spokane, WA
• Providers in Spokane, WA by specialty
• General Practice Dentistry in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.