Eric Mitchell Fooksman, D.D.S

Primary specialty

DentistTaxonomy code 122300000X

License

15426 Issued in MD

Practice address

22 Kent Town Market
Chester, MD 21619-2632

Phone

(410) 643-5500

NPI assigned

Jul 10, 2013

Last updated

Jun 14, 2023By 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

Enrolled in PA

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

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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

• F.W.B. Dental LLC

  dba Eastern Shore Dental Care

  • General Practice Dentistry
  • Chester, MD
  • NPI 1932883444
  NPD Authorized official
• Billings & Murphy, D.D.S., P.a.

  • Dentist
  • Chester, MD
  • NPI 1841316304
  NPD (past)
• Dental One Associates Annapolis PC

  • Dentist
  • Annapolis, MD
  • NPI 1588788871
  NPD (past)

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

{
    "created_epoch": "1373414400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686700800000",
    "number": "1710328414",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22 KENT TOWN MARKET",
            "city": "CHESTER",
            "state": "MD",
            "postal_code": "216192632",
            "telephone_number": "410-643-5500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22 KENT TOWN MARKET",
            "city": "CHESTER",
            "state": "MD",
            "postal_code": "216192632",
            "telephone_number": "410-643-5500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOOKSMAN",
        "first_name": "ERIC",
        "middle_name": "MITCHELL",
        "name_prefix": "Dr.",
        "credential": "D.D.S",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-07-10",
        "last_updated": "2023-06-14",
        "certification_date": "2023-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MD",
            "license": "15426",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Easton Snoring and Sleep Apnea Center LLC
• Deon Edgerson-George
• F.W.B. Dental LLC (Eastern Shore Dental Care)
• Fitness Forum of Maryland, LLC
• Joyce Flynt, NP
• Erin Elizabeth Golueke, DDS
• Louis Florentine Gonzales, IDC
• Ashley Good
• Yididya Zegeye Hambissa, PHARMD
• Julia Hogan, PHARMD

• Dentist in Chester, MD
• Providers in Chester, MD by specialty
• Dentist in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.