NPIMap

Individual provider Active NPI

Todd Paul Fairbanks, DDS

  • Oral and Maxillofacial Surgery (Dentist)
  • Seattle, WA
National Provider Identifier
1568693240
Registry record updated Jul 29, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
DR 60096066 Issued in WA
Practice address
University of Washington Oral Surgery Dept
Box 357134, 1959 NE Pacific St.
Seattle, WA 98195-7134
Phone
(206) 543-7722
Fax
(206) 685-7222
NPI assigned
Jul 29, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist) 1223S0112X DR 60096066 WA Primary

Addresses

Primary practice location

University of Washington Oral Surgery Dept
Box 357134, 1959 NE Pacific St.
Seattle, WA 98195-7134

Mailing address

University of Washington Oral Surgery Dept
Box 357134, 1959 NE Pacific St.
Seattle, WA 98195-7134
Phone (206) 543-7722

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
DR 60096066WAMDOral and Maxillofacial Surgery (Dentist)

NPI Registry JSON

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

{
    "created_epoch": "1248825600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1248825600000",
    "number": "1568693240",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "UNIVERSITY OF WASHINGTON ORAL SURGERY DEPT",
            "address_2": "BOX 357134, 1959 NE PACIFIC ST.",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981957134",
            "telephone_number": "206-543-7722",
            "fax_number": "206-685-7222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "UNIVERSITY OF WASHINGTON ORAL SURGERY DEPT",
            "address_2": "BOX 357134, 1959 NE PACIFIC ST.",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981957134",
            "telephone_number": "206-543-7722",
            "fax_number": "206-685-7222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAIRBANKS",
        "first_name": "TODD",
        "middle_name": "PAUL",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-07-29",
        "last_updated": "2009-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "WA",
            "license": "DR 60096066",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2009; 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.