Zane Grey Mills, DDS

Individual provider Active NPI General Practice Dentistry · Fairfax, OK

NPI 1134978596 · NPPES record last updated Nov 4, 2024

Key facts

NPI
1134978596
Entity type
Individual (NPI type 1)
Primary specialty
General Practice Dentistry 1223G0001X
License
7850 (OK)
Practice address
161 N 2ND St
Fairfax, OK 74637-2063
Phone
(620) 216-0466
NPI assigned
May 16, 2024
Sex
Male
Sole proprietor
No

Organizations & group practices 3

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

Medicare Care Compare profile

Specialty
Dentist
Education
University of Oklahoma College of Dentistry, 2024
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

212 N Main St
Fairfax, OK 74637-3023

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
7850OKMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Fairfax Dental Office PLLC Current
since Nov 10, 2024
Accepting new patients
Fairfax Medical Facilities Inc Past Accepting new patients
Fairfax Medical Facilities Inc Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 7850 OK Yes

Addresses

Primary practice location

161 N 2ND St
Fairfax, OK 74637-2063

Mailing address

158 N 2ND St
Fairfax, OK 74637
Phone (620) 216-0466

Other providers in Fairfax, OK

All providers in Fairfax, OK · General Practice Dentistry in Oklahoma

Sources for this page

Verify at the official NPI Registry.