Douglas W Fain, DDS.,MD

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

6713 Issued in KS

Practice address

20168 W 153Rd St
Olathe, KS 66062-9131

Phone

(913) 839-9709

Fax

(913) 839-9471

NPI assigned

Jan 17, 2006

Last updated

Mar 25, 2017By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Oct 30, 2018 through Oct 30, 2026

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Oral & Facial Surgery Associates

  • Oral and Maxillofacial Surgery (Dentist)
  • Prairie Village, KS
  • NPI 1023027836
  NPD (past)

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

{
    "created_epoch": "1137456000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1490400000000",
    "number": "1013996115",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20168 W 153RD ST",
            "city": "OLATHE",
            "state": "KS",
            "postal_code": "660629131",
            "telephone_number": "913-839-9709",
            "fax_number": "913-839-9471"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20168 W 153RD ST",
            "city": "OLATHE",
            "state": "KS",
            "postal_code": "660629131",
            "telephone_number": "913-839-9709",
            "fax_number": "913-839-9471"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAIN",
        "first_name": "DOUGLAS",
        "middle_name": "W",
        "credential": "DDS.,MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-01-17",
        "last_updated": "2017-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "KS",
            "license": "6713",
            "primary": true
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "MO",
            "license": "13540",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Eye Care, LLC (Discover Vision Centers)
• Eye-Pros of Olathe Inc.
• Eyemart Express LLC
• Jennifer Thompson Eyler, M.D.
• Tiyamike Ezala, NP
• Christopher Fairleigh, M.S. SLP
• Tyler Falck, LMLP
• Fales Pediatric Dentistry
• John Thomas Fales Jr., D.D.S., M.S.
• Kevin Fall, PH.D.

• Oral and Maxillofacial Surgery (Dentist) in Olathe, KS
• Providers in Olathe, KS by specialty
• Oral and Maxillofacial Surgery (Dentist) in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.