Michael S. Pharaoh, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

12481 Issued in TX

Practice address

205 S Cypress St
Pecos, TX 79772-3102

Phone

(432) 445-2671

NPI assigned

Jun 30, 2006

Last updated

Jul 8, 2007By 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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1151625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1487682969",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "205 S CYPRESS ST",
            "city": "PECOS",
            "state": "TX",
            "postal_code": "797723102",
            "telephone_number": "432-445-2671"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 S CYPRESS ST",
            "city": "PECOS",
            "state": "TX",
            "postal_code": "797723102",
            "telephone_number": "432-445-2671"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHARAOH",
        "first_name": "MICHAEL",
        "middle_name": "S.",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-30",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "12481",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Orville D Cerna Medical Clinic, LLC
• Pecos Ambulance Service (Pecos Volunteer Ambulance Service Inc.)
• Pecos Dental PC (Pecos Dental)
• Pecos-Barstow-Toya Isd
• Pecos-Barstow-Toyah Isd
• Pigman Avenue Emergency Physicians PLLC
• Podiatric Medical Partners of Texas, PA (Permian Basin Foot & Ankle)
• Carlos Xavier Quinones Cruz, PA-C
• Daniel Quintana
• John Thomas Rediger, RPH

• General Practice Dentistry in Pecos, TX
• Providers in Pecos, TX by specialty
• General Practice Dentistry in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.