Matthew Lane Fairburn, D.M.D.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

3292-04 Issued in MS

Practice address

865 South Pear Orchard Road
Ridgeland, MS 39157

Phone

(601) 956-4007

Fax

(601) 956-2901

NPI assigned

Oct 12, 2006

Last updated

Jul 18, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

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": "1160611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1184716800000",
    "number": "1689764722",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "865 SOUTH PEAR ORCHARD ROAD",
            "city": "RIDGELAND",
            "state": "MS",
            "postal_code": "39157",
            "telephone_number": "601-956-4007",
            "fax_number": "601-956-2901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "865 SOUTH PEAR ORCHARD ROAD",
            "city": "RIDGELAND",
            "state": "MS",
            "postal_code": "39157",
            "telephone_number": "601-956-4007",
            "fax_number": "601-956-2901"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAIRBURN",
        "first_name": "MATTHEW",
        "middle_name": "LANE",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-12",
        "last_updated": "2007-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MS",
            "license": "3292-04",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• General Practice Dentistry in Ridgeland, MS
• Providers in Ridgeland, MS by specialty
• General Practice Dentistry in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 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.