Siuhung Fan, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

10739 Issued in FL

Practice address

211 E Lime St
Lakeland, FL 33801-4607

Phone

(863) 683-4091

Fax

(863) 687-8651

NPI assigned

Jul 24, 2006

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 FL

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

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

{
    "created_epoch": "1153699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1336161900",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "211 E LIME ST",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338014607",
            "telephone_number": "863-683-4091",
            "fax_number": "863-687-8651"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "211 E LIME ST",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338014607",
            "telephone_number": "863-683-4091",
            "fax_number": "863-687-8651"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAN",
        "first_name": "SIUHUNG",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-24",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "10739",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Family Chiropractic Health Center
• Family Counseling of Lakeland, LLC
• Family Eye Center South LLC
• Family Life Counseling Center
• Family Psychological Services of Lakeland, LLC
• Jeanne-Marie Fanelli, MD
• Kammna B Farag
• Maher Nashed Farag, BDMS
• Mark M Farag, D.M.D.
• Fare Way Transportation

• General Practice Dentistry in Lakeland, FL
• Providers in Lakeland, FL by specialty
• General Practice Dentistry in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.