Mark A. Faught, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

019019181 Issued in IL

Practice address

730 Enterprise Drive
Rantoul, IL 61866-3689

Phone

(217) 359-9900

Fax

(217) 892-8869

NPI assigned

Jun 2, 2005

Reactivated

Apr 10, 2006

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1117670400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1424995200000",
    "number": "1942204201",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "730 ENTERPRISE DRIVE",
            "city": "RANTOUL",
            "state": "IL",
            "postal_code": "618663689",
            "telephone_number": "217-359-9900",
            "fax_number": "217-892-8868"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "730 ENTERPRISE DRIVE",
            "city": "RANTOUL",
            "state": "IL",
            "postal_code": "618663689",
            "telephone_number": "217-359-9900",
            "fax_number": "217-892-8869"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAUGHT",
        "first_name": "MARK",
        "middle_name": "A.",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-02",
        "last_updated": "2015-02-27",
        "deactivation_date": "2006-03-21",
        "reactivation_date": "2006-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019019181",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Maureen Dickman, M.S. CCC-SLP
• Jacob Ediba
• Educational SVC Region Office
• Empowerme Rehabilitation Illinois, LLC
• Danielle Marie Faber, PHARMD
• Alexis Fiscus
• Elizabeth Ann Franklin, APRN, FNP-C
• Thomas L Franzen, MD
• Krystal L Frerichs, PHARMD
• Gillian Gawenda

• General Practice Dentistry in Rantoul, IL
• Providers in Rantoul, IL by specialty
• General Practice Dentistry in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2015; 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.