Michelle Fackler, DMD

Primary specialty

ProsthodonticsTaxonomy code 1223P0700X

License

069155 Issued in NY

Practice address

375 Fulton St
Farmingdale, NY 11735-3454

Phone

(516) 249-1188

NPI assigned

Apr 3, 2018

Last updated

Nov 20, 2021By the provider in NPPES

Sex

Female

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

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.

• Ferrari Alderi and Associates DDS

  • General Practice Dentistry
  • Farmingdale, NY
  • NPI 1891802260
  NPD (past)
• Greater Long Island Dental Health Associates

  • Dentist
  • Massapequa, NY
  • NPI 1508951591
  NPD (past)

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

{
    "created_epoch": "1522713600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1637366400000",
    "number": "1497251961",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19 ROBERTA LN",
            "city": "COMMACK",
            "state": "NY",
            "postal_code": "117253815",
            "telephone_number": "516-661-5295"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "375 FULTON ST",
            "city": "FARMINGDALE",
            "state": "NY",
            "postal_code": "117353454",
            "telephone_number": "516-249-1188"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "101 New York Ave",
            "address_purpose": "LOCATION",
            "city": "Massapequa",
            "state": "NY",
            "postal_code": "117584910",
            "country_code": "US",
            "telephone_number": "516-798-4223",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FACKLER",
        "first_name": "MICHELLE",
        "name_prefix": "Ms.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-04-03",
        "last_updated": "2021-11-20",
        "certification_date": "2021-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0700X",
            "taxonomy_group": "",
            "desc": "Dentist, Prosthodontics",
            "state": "NY",
            "license": "069155",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Evolution Physical Therapy Ny PLLC
• Exact Medical Services PLLC
• Eyeglass Depot Optical
• Franklin Ezeorah
• Paulet Facey
• Ronald C. Fagan, M.D.
• Nicholas Famigletti, DMD
• Irine Farag, LMT
• Cynthia Farina, LMT
• Farmingdale Adult Day Care Center Inc

• Prosthodontics in Farmingdale, NY
• Providers in Farmingdale, NY by specialty
• Prosthodontics in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 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.