Individual provider Active NPI

William Jacob Fooks, DMD

  • Dentist
  • Fort Thomas, KY
National Provider Identifier
1730814146
Registry record updated Oct 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
10790 Issued in KY
Practice address
725 Alexandria Pike Ste 100
Fort Thomas, KY 41075-2169
Phone
(859) 781-0221
NPI assigned
Jul 19, 2022
Last updated
Oct 9, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 9, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 30.027019 OH
Dentist 122300000X 10790 KY Primary

Addresses

Primary practice location

725 Alexandria Pike Ste 100
Fort Thomas, KY 41075-2169

Mailing address

5221 Waynetowne CT
Dayton, OH 45424-2124

Other practice location 1

2020 Alverson Dr
Paris, KY 40361-2205
Phone (859) 987-4775

Other practice location 2

5221 Waynetowne Ct
Dayton, OH 45424-2124
Phone (937) 237-0360

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
10790KYMDDentist
30.027019OHMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Sleep Oasis LLC CurrentSince Oct 15, 2023 Accepting new patients
Tailwater Practice Partners, LLC Dentist CurrentSince Jul 21, 2024 Accepting new patients
Fooks Dental LLC Current Accepting new patients
Dental Smile Professionals Dayton Ohio LLC PastSince Nov 1, 2022 Accepting new patients
Herald Family Denistry PLLC PastSince Oct 15, 2023 Accepting new patients
Scott B Phillippi DDS LLC PastSince Nov 1, 2022 Accepting new patients

Locations

725 Alexandria Pike
Ste 100
Fort Thomas, KY 41075
Phone (859) 781-0221

2020 Alverson Dr
Paris, KY 40361
Phone (859) 987-4775

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1658188800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696809600000",
    "number": "1730814146",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5221 WAYNETOWNE CT",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454242124"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "725 ALEXANDRIA PIKE STE 100",
            "city": "FORT THOMAS",
            "state": "KY",
            "postal_code": "410752169",
            "telephone_number": "859-781-0221"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2020 Alverson Dr",
            "address_purpose": "LOCATION",
            "city": "Paris",
            "state": "KY",
            "postal_code": "403612205",
            "country_code": "US",
            "telephone_number": "859-987-4775",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5221 Waynetowne Ct",
            "address_purpose": "LOCATION",
            "city": "Dayton",
            "state": "OH",
            "postal_code": "454242124",
            "country_code": "US",
            "telephone_number": "937-237-0360",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FOOKS",
        "first_name": "WILLIAM",
        "middle_name": "JACOB",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-07-19",
        "last_updated": "2023-10-09",
        "certification_date": "2023-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "OH",
            "license": "30.027019",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "KY",
            "license": "10790",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Thomas, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2023; 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.