Individual provider Active NPI

Ronald Faram, D.D.S.

  • Oral and Maxillofacial Pathology Dentistry
  • Oklahoma City, OK
National Provider Identifier
1689929184
Registry record updated Jun 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Pathology DentistryTaxonomy code 1223P0106X
License
6 Issued in OK
Practice address
1201 N Stonewall Ave
Oklahoma City, OK 73117-1214
Phone
(405) 271-5714
Fax
(405) 271-2405
NPI assigned
Jul 20, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Public Health Dentistry 1223D0001X 6433 OK
Oral and Maxillofacial Pathology Dentistry 1223P0106X 6433 OK
Oral and Maxillofacial Pathology Dentistry 1223P0106X 6 OK Primary

Addresses

Primary practice location

1201 N Stonewall Ave
Oklahoma City, OK 73117-1214

Mailing address

1201 N Stonewall Ave Ste 286
Oklahoma City, OK 73117-1214
Phone (405) 271-4333

Other identifiers 1

IdentifierTypeStateIssuer
200006220AMedicaidOK

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210122001890 OK Practitioner - Dentist 7719279058 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Dentist
Education
University of Oklahoma College of Dentistry, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1201 N Stonewall Ave
Oklahoma City, OK 73117-1214
Phone (405) 271-4333

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6433OKMDPublic Health Dentist
6OKMDPerfusionist

Practice roles

OrganizationSpecialtyStatusNew patients
Board of Regents of the University of Oklahoma - Ou Denitstry CurrentSince Nov 1, 2020 Accepting new patients
Board of Regents of the University of Oklahoma CurrentSince Mar 13, 2021 Accepting new patients

Locations

1201 N Stonewall Ave
Ste 286
Oklahoma City, OK 73117

1201 N Stonewall Ave
Ste 321
Oklahoma City, OK 73117

1201 N Stonewall Ave
Oklahoma City, OK 73117
Phone (405) 271-5714

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1342742400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718064000000",
    "number": "1689929184",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1201 N STONEWALL AVE STE 286",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731171214",
            "telephone_number": "405-271-4333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201 N STONEWALL AVE",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731171214",
            "telephone_number": "405-271-5714",
            "fax_number": "405-271-2405"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FARAM",
        "first_name": "RONALD",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-07-20",
        "last_updated": "2024-06-11",
        "certification_date": "2024-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223D0001X",
            "taxonomy_group": "",
            "desc": "Dentist, Dental Public Health",
            "state": "OK",
            "license": "6433",
            "primary": false
        },
        {
            "code": "1223P0106X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Pathology",
            "state": "OK",
            "license": "6433",
            "primary": false
        },
        {
            "code": "1223P0106X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Pathology",
            "state": "OK",
            "license": "6",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200006220A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

Verify at the official NPI Registry.