Fangman Oral and Facial Surgery Professional LLC

Primary specialty

Oral and Maxillofacial Surgery Clinic/CenterTaxonomy code 261QS0112X

Legal business name

FANGMAN ORAL AND FACIAL SURGERY PROFESSIONAL LLC

Practice address

5600 W 44TH Ave Unit 100
Denver, CO 80212-7339

Phone

(720) 328-4990

Fax

(720) 328-4994

NPI assigned

Feb 4, 2022

Organization subpart

No

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

Authorized official

Name

Dr. Brian Fangman, DDS

Title

Owner/Oral Surgeon

Phone

(720) 328-4990

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Altitude Oral and Facial Surgery PLLC Doing business as

Tax ID family

Fangman Oral and Facial Surgery Professional LLC5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

• Fangman Oral and Facial Surgery Professional LLC

  • Oral and Maxillofacial Surgery Clinic/Center
  • Commerce City, CO
  • NPI 1386398667
  NPD tax ID
• Fangman Oral and Facial Surgery Professional LLC

  • Oral and Maxillofacial Surgery Clinic/Center
  • Lone Tree, CO
  • NPI 1518612266
  NPD tax ID
• Fangman Oral and Facial Surgery Professional LLC

  • Oral and Maxillofacial Surgery Clinic/Center
  • Windsor, CO
  • NPI 1750038089
  NPD tax ID
• Fangman Oral and Facial Surgery Professional LLC

  • Oral and Maxillofacial Surgery (Dentist)
  • Denver, CO
  • NPI 1952791964
  NPD tax ID

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

{
    "created_epoch": "1643932800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1644278400000",
    "number": "1093469447",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5600 W 44TH AVE UNIT 100",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802127339",
            "telephone_number": "720-328-4990",
            "fax_number": "720-328-4994"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5600 W 44TH AVE UNIT 100",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802127339",
            "telephone_number": "720-328-4990",
            "fax_number": "720-328-4994"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FANGMAN ORAL AND FACIAL SURGERY PROFESSIONAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-02-04",
        "last_updated": "2022-02-08",
        "certification_date": "2022-02-08",
        "status": "A",
        "authorized_official_last_name": "FANGMAN",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_title_or_position": "OWNER/ORAL SURGEON",
        "authorized_official_telephone_number": "720-328-4990",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QS0112X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Oral and Maxillofacial Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL NPI",
            "identifier": "1609027556",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1952791964",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Altitude Oral and Facial Surgery PLLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jacquelyn Fanciulli
• Kevin Fanciulli, PHARM.D.
• Hsiao-Wei Fang, L.AC.
• Fangman & Ivey Oral and Facial Surgery PLLC
• Fangman & Ivey Oral and Facial Surgery PLLC
• Fangman Oral and Facial Surgery Professional LLC
• Brian Fangman, DDS
• Gabrielle Danae Fangman, MD
• Timothy Lee Fangmeier, LPC
• Alicia Sharon Fankell, LCSW

• Oral and Maxillofacial Surgery Clinic/Center in Denver, CO
• Providers in Denver, CO by specialty
• Oral and Maxillofacial Surgery Clinic/Center in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2022; 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.