Randolph Kelly Faulk Jr., DDS

Primary specialty

DentistTaxonomy code 122300000X

License

6030 Issued in NC

Practice address

1806 Doctors Dr
Sanford, NC 27330

Phone

(919) 774-9419

Fax

(919) 774-1404

NPI assigned

May 12, 2006

Last updated

Jul 13, 2026By 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 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NC

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

Practice roles

Interoperability endpoints

• Direct secure messaging: randolph.faulkjr.p1@direct.personfamily.nextgenshare.com

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.

• R Kelly Faulk Jr DDS PA

  • Dental Clinic/Center
  • Sanford, NC
  • NPI 1235116724
  NPD (past) Authorized official

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

{
    "created_epoch": "1147392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1407807605",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1806 DOCTORS DR",
            "city": "SANFORD",
            "state": "NC",
            "postal_code": "27330",
            "telephone_number": "919-774-9419",
            "fax_number": "919-774-1404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1806 DOCTORS DR",
            "city": "SANFORD",
            "state": "NC",
            "postal_code": "27330",
            "telephone_number": "919-774-9419",
            "fax_number": "919-774-1404"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAULK",
        "first_name": "RANDOLPH",
        "middle_name": "KELLY",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-12",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NC",
            "license": "6030",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8992816",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Family Preservation Services of NC, Inc Sanford-Sacot
• Family Preservation Services of North Carolina, Inc-Sanford-Saiop
• Ken-Shih Fan, DO
• Christina Farmer
• Fast Pace Kentucky PLLC (Fast Pace Health)
• Kaprice Reevea Faust
• Fayetteville Vamc
• Wanda Cheatham Feldt
• Fenominal Home Care Inc.
• Fenominal Services, LLP

• Dentist in Sanford, NC
• Providers in Sanford, NC by specialty
• Dentist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; 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.