Compass Dental, LLC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

License

DN011627 Issued in GA

Legal business name

COMPASS DENTAL, LLC

Practice address

7130 Hodgson Memorial Dr
Ste 103
Savannah, GA 31406-1526

Phone

(912) 352-3955

NPI assigned

Apr 5, 2017

Organization subpart

No

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

Authorized official

Name

Dr. Charles R Fana Jr., DMDNPI 1164551057

Title

Member

Phone

(912) 352-3955

Specialties & licenses 2

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Charles Richard Fana Jr., DMD

  • General Practice Dentistry
  • Savannah, GA
  • NPI 1164551057
  NPD (past) Authorized official

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

{
    "created_epoch": "1491350400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1491350400000",
    "number": "1356874507",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7130 HODGSON MEMORIAL DR",
            "address_2": "STE 103",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314061526"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7130 HODGSON MEMORIAL DR",
            "address_2": "STE 103",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314061526",
            "telephone_number": "912-352-3955"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMPASS DENTAL, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-04-05",
        "last_updated": "2017-04-05",
        "status": "A",
        "authorized_official_last_name": "FANA",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "912-352-3955",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "GA",
            "license": "DN011627",
            "primary": true
        },
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "SC",
            "license": "3563",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Dental Clinic/Center in Savannah, GA
• Providers in Savannah, GA by specialty
• Dental Clinic/Center in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2017; 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.