NPIMap

Organization Active NPI

Michael W Fuqua DDS

  • General Practice Dentistry
  • Weslaco, TX
National Provider Identifier
1861572950
Registry record updated Jul 29, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
16265 Issued in TX
Legal business name
MICHAEL W FUQUA DDS
Practice address
713 S Texas
Weslaco, TX 78596
Phone
(956) 969-2960
Fax
(956) 969-3241
NPI assigned
Oct 16, 2006
Last updated
Jul 29, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2008

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

Authorized official

Name
Dr. Michael W Fuqua, DDSNPI 1972681914
Title
Owner
Phone
(956) 425-7474

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X 16265 TX Primary

Addresses

Primary practice location

713 S Texas
Weslaco, TX 78596

Mailing address

713 S Texas
Weslaco, TX 78596
Phone (956) 969-2960

Other identifiers 2

IdentifierTypeStateIssuer
120848004MedicaidTX
16265-02OtherTXTEXAS CHIPS

Other names 1

  • Advanced Dental Associates Other name

National Provider Directory

National Provider Directory
Tax ID family
Advanced Dental Associates2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1160956800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1217289600000",
    "number": "1861572950",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "713 S TEXAS",
            "city": "WESLACO",
            "state": "TX",
            "postal_code": "78596",
            "telephone_number": "956-969-2960",
            "fax_number": "956-969-3241"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "713 S TEXAS",
            "city": "WESLACO",
            "state": "TX",
            "postal_code": "78596",
            "telephone_number": "956-969-2960",
            "fax_number": "956-969-3241"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHAEL W FUQUA DDS",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-16",
        "last_updated": "2008-07-29",
        "status": "A",
        "authorized_official_last_name": "FUQUA",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "956-425-7474",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "16265",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "120848004",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TEXAS CHIPS",
            "identifier": "16265-02",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Advanced Dental Associates",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Weslaco, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2008; 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.