Michael David Fast, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

2269-86 Issued in MS

Practice address

2500 North State Street
Jackson, MS 39216

Phone

(601) 984-6001

Fax

(601) 815-3903

NPI assigned

Jan 22, 2007

Last updated

Mar 7, 2023By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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 MO

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

Practice roles

Interoperability endpoints

• Direct secure messaging: mfast174719@ummc.direct-ci.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.

• Access Family Health Services, Inc.

  • Community/Retail Pharmacy
  • Tremont, MS
  • NPI 1124618525
  NPD (past)
• Access Family Health Services, Inc.

  dba ACCESS Family Dental Clinic

  • Community Health Clinic/Center
  • Smithville, MS
  • NPI 1932219524
  NPD (past)
• Moore Family Dental, PLLC

  dba Columbia Family Dental

  • General Practice Dentistry
  • Columbia, MS
  • NPI 1992695571
  NPD (past)

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

{
    "created_epoch": "1169424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1447304357",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2500 NORTH STATE STREET",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "39216",
            "telephone_number": "601-984-6001",
            "fax_number": "662-651-7115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 NORTH STATE STREET",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "39216",
            "telephone_number": "601-984-6001",
            "fax_number": "601-815-3903"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "60024 Olive St",
            "address_purpose": "LOCATION",
            "city": "Smithville",
            "state": "MS",
            "postal_code": "388709719",
            "country_code": "US",
            "telephone_number": "662-651-7111",
            "fax_number": "662-651-7115",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FAST",
        "first_name": "MICHAEL",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-22",
        "last_updated": "2023-03-07",
        "certification_date": "2022-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MS",
            "license": "2269-86",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Paulisha Trenise Farrish, M.S., CCC-SLP
• Ryan Farthing, NP
• Anika Faruque
• Farzad Faryabi, DPM
• Olawale Fashina, MD
• Sarah Faucette, AUD
• Rachael W. Faught, D.O.
• Whitney Faulconer, D.O.
• Catherine Faulk, M.D.
• John M Faust, M.D.

• Dentist in Jackson, MS
• Providers in Jackson, MS by specialty
• Dentist in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.