Individual provider Active NPI

Mike L Fuesting, D.M.D.

  • General Practice Dentistry
  • Danville, IL
National Provider Identifier
1699778159
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Practice address
1004 N Gilbert St
Danville, IL 61832-3849
Phone
(217) 442-4267
Fax
(217) 442-4284
NPI assigned
May 27, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X IL Primary

Addresses

Primary practice location

1004 N Gilbert St
Danville, IL 61832-3849

Mailing address

1004 N Gilbert St
Danville, IL 61832-3849
Phone (217) 442-4267

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)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1117152000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1699778159",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1004 N GILBERT ST",
            "city": "DANVILLE",
            "state": "IL",
            "postal_code": "618323849",
            "telephone_number": "217-442-4267",
            "fax_number": "217-442-4284"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1004 N GILBERT ST",
            "city": "DANVILLE",
            "state": "IL",
            "postal_code": "618323849",
            "telephone_number": "217-442-4267",
            "fax_number": "217-442-4284"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FUESTING",
        "first_name": "MIKE",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-05-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Danville, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.