Individual provider Active NPI

Christopher Fairbanks, DMD

  • General Practice Dentistry
  • Mills River, NC
National Provider Identifier
1144742966
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
10779 Issued in NC
Practice address
3340 Boylston Hwy Unit 30
Mills River, NC 28759-4103
Phone
(828) 891-7999
Fax
(828) 891-6002
NPI assigned
Jul 13, 2017
Last updated
Jul 21, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 10779 NC Primary

Addresses

Primary practice location

3340 Boylston Hwy Unit 30
Mills River, NC 28759-4103

Mailing address

3340 Boylston Hwy Unit 30
Mills River, NC 28759-4103
Phone (828) 891-7999

Other identifiers 1

IdentifierTypeStateIssuer
10779OtherNCSTATE OF NC DENTAL EXAMINERS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
10779NCMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Stohl & Pearce Mills River Dental Partnership CurrentSince Sep 11, 2022 Accepting new patients

Locations

3340 Boylston Hwy
Unit 30
Mills River, NC 28759
Phone (828) 891-7999

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1499904000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1144742966",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3340 BOYLSTON HWY UNIT 30",
            "city": "MILLS RIVER",
            "state": "NC",
            "postal_code": "287594103",
            "telephone_number": "828-891-7999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3340 BOYLSTON HWY UNIT 30",
            "city": "MILLS RIVER",
            "state": "NC",
            "postal_code": "287594103",
            "telephone_number": "828-891-7999",
            "fax_number": "828-891-6002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAIRBANKS",
        "first_name": "CHRISTOPHER",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-07-13",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NC",
            "license": "10779",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE OF NC DENTAL EXAMINERS",
            "identifier": "10779",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mills River, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 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.