Fady Fakhoury PA

Primary specialty

DentistTaxonomy code 122300000X

License

DN16160 Issued in FL

Legal business name

FADY FAKHOURY PA

Practice address

10911 Bonita Beach Rd SE
Suite 105
Bonita Springs, FL 34135-9053

Phone

(239) 495-9900

Fax

(239) 495-6256

NPI assigned

Jan 5, 2016

Organization subpart

No

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

Authorized official

Name

Dr. Fady I Fakhoury, DDSNPI 1265514418

Title

Owner

Phone

(239) 495-9900

Specialties & licenses 1

Addresses

Locations

Practitioners 2

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

• Fady I Fakhoury, DDS

  • General Practice Dentistry
  • Bonita Springs, FL
  • NPI 1265514418
  NPD (past) Authorized official
• Laith Yousif, D.D.S.

  • Dentist
  • Bonita Springs, FL
  • NPI 1649163452
  NPD (past)

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

{
    "created_epoch": "1451952000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1451952000000",
    "number": "1447616578",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10911 BONITA BEACH RD SE",
            "address_2": "SUITE 105",
            "city": "BONITA SPRINGS",
            "state": "FL",
            "postal_code": "341359053",
            "telephone_number": "239-495-9900",
            "fax_number": "239-495-6256"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10911 BONITA BEACH RD SE",
            "address_2": "SUITE 105",
            "city": "BONITA SPRINGS",
            "state": "FL",
            "postal_code": "341359053",
            "telephone_number": "239-495-9900",
            "fax_number": "239-495-6256"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FADY FAKHOURY PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-01-05",
        "last_updated": "2016-01-05",
        "status": "A",
        "authorized_official_last_name": "FAKHOURY",
        "authorized_official_first_name": "FADY",
        "authorized_official_middle_name": "I",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "239-495-9900",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "FL",
            "license": "DN16160",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Dentist in Bonita Springs, FL
• Providers in Bonita Springs, FL by specialty
• Dentist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2016; 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.