Individual provider Active NPI

Michael Paul Fauks, DDS

  • Dentist
  • Oklahoma City, OK
National Provider Identifier
1194769646
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
452 Issued in OK
Practice address
3400 NW Expressway
Suite 600
Oklahoma City, OK 73112-4493
Phone
(405) 946-6136
Fax
(405) 946-6812
NPI assigned
Jun 15, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 452 OK Primary

Addresses

Primary practice location

3400 NW Expressway
Suite 600
Oklahoma City, OK 73112-4493

Mailing address

3400 NW Expressway
Suite 600
Oklahoma City, OK 73112-4493
Phone (405) 946-6136

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20160624000821 OK Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 9436440260

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
452OKMDCounselor
3771OKMDDiagnostic Radiology Physician

NPI Registry JSON

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

{
    "created_epoch": "1150329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1194769646",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3400 NW EXPRESSWAY",
            "address_2": "SUITE 600",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731124493",
            "telephone_number": "405-946-6136",
            "fax_number": "405-946-6812"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3400 NW EXPRESSWAY",
            "address_2": "SUITE 600",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731124493",
            "telephone_number": "405-946-6136",
            "fax_number": "405-946-6812"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAUKS",
        "first_name": "MICHAEL",
        "middle_name": "PAUL",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-15",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "OK",
            "license": "452",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

Verify at the official NPI Registry.