Bryan Mason Faulk, DENTAL TECHNICIAN

Primary specialty

Dental AssistantTaxonomy code 126800000X

Practice address

BLDG #50 Farenholt Ave
Agana Heights, GU 96910

Phone

(671) 344-9493

NPI assigned

Feb 22, 2023

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1677024000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677024000000",
    "number": "1346948908",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "MIL",
            "address_1": "PSC 455 BOX 208",
            "city": "FPO",
            "state": "AP",
            "postal_code": "965400003",
            "telephone_number": "671-344-9493"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "BLDG #50 FARENHOLT AVE",
            "city": "AGANA HEIGHTS",
            "state": "GU",
            "postal_code": "96910",
            "telephone_number": "671-344-9493"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAULK",
        "first_name": "BRYAN",
        "middle_name": "MASON",
        "credential": "DENTAL TECHNICIAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-02-22",
        "last_updated": "2023-02-22",
        "certification_date": "2023-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "126800000X",
            "taxonomy_group": "",
            "desc": "Dental Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Taylor Desrosiers, MD, MBA
• Taylor Dickinson, CRNA
• Maryann Lumba Dizon, RN
• Matthew Edinger, DO
• Erica Dawn T Escalante, LCSW
• Shirae Antoinette Cepeda Fejeran, RN
• Kathleen Mae Cajigal Fernandez, RN
• Jamie Lynn Fitch, M.D.
• Shanae A Fletcher
• Andres Higareda Garcia

• All providers in Agana Heights, GU
• Dental Assistant in Guam

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2023; 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.