Individual provider Active NPI

Michael John Fourman, DDS

  • General Practice Dentistry
  • Greenville, OH
National Provider Identifier
1255452389
Registry record updated Apr 25, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
14663 Issued in OH
Practice address
5735 Meeker Rd
Greenville, OH 45331-1180
Phone
(937) 547-2326
Fax
(937) 548-3552
NPI assigned
Apr 3, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 25, 2012

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 14663 OH Primary

Addresses

Primary practice location

5735 Meeker Rd
Greenville, OH 45331-1180

Mailing address

5735 Meeker Rd
Greenville, OH 45331-1180
Phone (937) 547-2326

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20150618000269 OH Practitioner - Dentist 0941511992 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
14663OHMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Family Health Services of Darke County, Inc. CurrentSince May 16, 2015 Accepting new patients
Family Health Services of Darke County Inc Current Accepting new patients
Family Health Services of Darke County, Inc. CurrentSince May 16, 2015 Accepting new patients

Locations

1101 Jackson St
Ste C
Greenville, OH 45331
Phone (937) 547-2319

5735 Meeker Rd
Greenville, OH 45331
Phone (937) 548-3806

5735 Meeker Rd
Ste 3
Greenville, OH 45331

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1175558400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1335312000000",
    "number": "1255452389",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5735 MEEKER RD",
            "city": "GREENVILLE",
            "state": "OH",
            "postal_code": "453311180",
            "telephone_number": "937-547-2326",
            "fax_number": "937-548-3552"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5735 MEEKER RD",
            "city": "GREENVILLE",
            "state": "OH",
            "postal_code": "453311180",
            "telephone_number": "937-547-2326",
            "fax_number": "937-548-3552"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOURMAN",
        "first_name": "MICHAEL",
        "middle_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-03",
        "last_updated": "2012-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OH",
            "license": "14663",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenville, OH

Sources for this page

Verify at the official NPI Registry.