Kristin L Fairbanks

Primary specialty

DentistTaxonomy code 122300000X

License

2901014071 Issued in MI

Practice address

520 Johnston St
Sault Sainte Marie, MI 49783-2122

Phone

(906) 632-6151

NPI assigned

Apr 13, 2006

Last updated

Jul 13, 2026By the provider in NPPES

Sex

Female

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 MI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1144886400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1750345047",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "520 JOHNSTON ST",
            "city": "SAULT SAINTE MARIE",
            "state": "MI",
            "postal_code": "497832122",
            "telephone_number": "906-632-6151"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "520 JOHNSTON ST",
            "city": "SAULT SAINTE MARIE",
            "state": "MI",
            "postal_code": "497832122",
            "telephone_number": "906-632-6151"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAIRBANKS",
        "first_name": "KRISTIN",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-13",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MI",
            "license": "2901014071",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Eric J. Siesel, O.D.P.C.
• Connor L Ernst
• Hannah Mae Erwin, MSOT, OTRL
• Matthew John Fabbro, MD
• Mary Fabis, RD
• Rashad Farha
• Janet Sue Farrish-Gravelle, LMSW
• Helen Sandra Farrish, LMSW
• Mark Fender, M.D.
• Raquel Fernandez-Earns, PH.D.

• Dentist in Sault Sainte Marie, MI
• Providers in Sault Sainte Marie, MI by specialty
• Dentist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; 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.