Michael John Fangman, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

105010 Issued in CA

Practice address

407 Brookside Ave
Redlands, CA 92373-4609

Phone

(909) 335-3644

NPI assigned

Apr 11, 2019

Last updated

Apr 21, 2021By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Rodney M. Collins Dental Corporation

  • Dental Clinic/Center
  • Redlands, CA
  • NPI 1003796640
  NPD

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

{
    "created_epoch": "1554940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618963200000",
    "number": "1386107795",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 W 6TH AVE",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802045182",
            "telephone_number": "303-436-6000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "407 BROOKSIDE AVE",
            "city": "REDLANDS",
            "state": "CA",
            "postal_code": "923734609",
            "telephone_number": "909-335-3644"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "301 W 6th Ave",
            "address_purpose": "LOCATION",
            "city": "Denver",
            "state": "CO",
            "postal_code": "802045182",
            "country_code": "US",
            "telephone_number": "303-436-6000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FANGMAN",
        "first_name": "MICHAEL",
        "middle_name": "JOHN",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-04-11",
        "last_updated": "2021-04-21",
        "certification_date": "2021-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "105010",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sabrina Fakhoury, APCC
• Elizabeth K Falk, PTA
• Brianna Fallon
• Family First Ventures Inc. (Home Instead)
• Family Primary and Specialty Care Clinic
• Fardad Borhani DMD Inc
• James R Farrage, DDS
• Alexis Fawcett
• FCMS
• Joanne Willie Frances Feild, LMFT

• General Practice Dentistry in Redlands, CA
• Providers in Redlands, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2021; 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.