NPIMap

Organization Active NPI

Jeffrey W. Fisk, D.M.D, P.S.C

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Somerset, KY
National Provider Identifier
1568557114
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
License
7491 Issued in KY
Legal business name
JEFFREY W. FISK, D.M.D, P.S.C
Practice address
221 East Somerset Church Road
Somerset, KY 42503
Phone
(606) 451-1448
Fax
(606) 451-8269
NPI assigned
Oct 3, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Jeffrey W Fisk, D.M.DNPI 1942990916
Title
President
Phone
(606) 451-1448

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthodontics and Dentofacial Orthopedics DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223X0400X 7491 KY Primary

Addresses

Primary practice location

221 East Somerset Church Road
Somerset, KY 42503

Mailing address

221 East Somerset Church Road
Somerset, KY 42503
Phone (606) 451-1448

Other identifiers 1

IdentifierTypeStateIssuer
60001179MedicaidKY

National Provider Directory

National Provider Directory

Locations

221 E Somerset Church Rd
Somerset, KY 42503
Phone (606) 451-1448

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1568557114",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "221 EAST SOMERSET CHURCH ROAD",
            "city": "SOMERSET",
            "state": "KY",
            "postal_code": "42503",
            "telephone_number": "606-451-1448",
            "fax_number": "606-451-8269"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "221 EAST SOMERSET CHURCH ROAD",
            "city": "SOMERSET",
            "state": "KY",
            "postal_code": "42503",
            "telephone_number": "606-451-1448",
            "fax_number": "606-451-8269"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JEFFREY W. FISK, D.M.D, P.S.C",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-03",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "FISK",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "606-451-1448",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.M.D"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "KY",
            "license": "7491",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "60001179",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Somerset, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.