John Willard Faul, D.M.D.

Primary specialty

DentistTaxonomy code 122300000X

License

008155 Issued in FL

Practice address

1111 S Dixie Fwy
New Smyrna Beach, FL 32168-7473

Phone

(386) 424-1631

NPI assigned

Dec 8, 2014

Last updated

Dec 8, 2014By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• John W Faul, DMD, PA

  • Dental Clinic/Center
  • Keystone Heights, FL
  • NPI 1447469879
  Authorized official Same address or phone

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

{
    "created_epoch": "1417996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1417996800000",
    "number": "1821496803",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1648 TAYLOR RD # 457",
            "city": "PORT ORANGE",
            "state": "FL",
            "postal_code": "321286753",
            "telephone_number": "321-626-7725"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 S DIXIE FWY",
            "city": "NEW SMYRNA BEACH",
            "state": "FL",
            "postal_code": "321687473",
            "telephone_number": "386-424-1631"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAUL",
        "first_name": "JOHN",
        "middle_name": "WILLARD",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-12-08",
        "last_updated": "2014-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "008155",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Daviana Figueroa
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• Tina Fischer-Carne, MD
• Elizabeth Kern Fisher, MA, CCC-SLP

• Dentist in New Smyrna Beach, FL
• Providers in New Smyrna Beach, FL by specialty
• Dentist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2014; 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.