Richard Fentem Jr., DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

4410 Issued in OK

Practice address

304 S Air Depot Blvd
Midwest City, OK 73110-4433

Phone

(405) 733-0002

Fax

(405) 741-2230

NPI assigned

Jun 23, 2006

Last updated

Jan 14, 2014By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OK

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.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

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.

• Ronald Montgomery Dental Group, PC

  dba Gentle Dental Mid Del City

  • General Practice Dentistry
  • Midwest City, OK
  • NPI 1093757437
  NPD (past)

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

{
    "created_epoch": "1151020800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1389657600000",
    "number": "1144256215",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "304 S AIR DEPOT BLVD",
            "city": "MIDWEST CITY",
            "state": "OK",
            "postal_code": "731104433",
            "telephone_number": "405-733-0002",
            "fax_number": "405-741-2230"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "304 S AIR DEPOT BLVD",
            "city": "MIDWEST CITY",
            "state": "OK",
            "postal_code": "731104433",
            "telephone_number": "405-733-0002",
            "fax_number": "405-741-2230"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FENTEM",
        "first_name": "RICHARD",
        "name_suffix": "Jr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-23",
        "last_updated": "2014-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OK",
            "license": "4410",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Angela Teressa Fay, SLP
• Fayyaz H. Hashmi, M.D., PC
• Kasha Featherstone
• Kasey Felker
• Braxton Feller
• Cherokee Leigh Ferguson
• Craigrison Leilan Ferguson
• John Clifford Ferguson V, DDS
• Joy Varee Ferreira, DPT
• Andrew Fiedler

• General Practice Dentistry in Midwest City, OK
• Providers in Midwest City, OK by specialty
• General Practice Dentistry in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2014; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.