Charles Robert Fahncke, D.D.S., M.S.

Primary specialty

ProsthodonticsTaxonomy code 1223P0700X

License

30-01-9124 Issued in OH

Practice address

3000 Arlington Ave
Mail Stop 1092
Toledo, OH 43614-2595

Phone

(419) 383-3776

NPI assigned

Nov 16, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1163635200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1298419200000",
    "number": "1952474868",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6038 WHITE EAGLE W",
            "city": "SYLVANIA",
            "state": "OH",
            "postal_code": "435609599",
            "telephone_number": "419-824-2108"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3000 ARLINGTON AVE",
            "address_2": "MAIL STOP 1092",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436142595",
            "telephone_number": "419-383-3776"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAHNCKE",
        "first_name": "CHARLES",
        "middle_name": "ROBERT",
        "name_prefix": "Dr.",
        "credential": "D.D.S., M.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-16",
        "last_updated": "2011-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0700X",
            "taxonomy_group": "",
            "desc": "Dentist, Prosthodontics",
            "state": "OH",
            "license": "30-01-9124",
            "primary": true
        },
        {
            "code": "1223P0700X",
            "taxonomy_group": "",
            "desc": "Dentist, Prosthodontics",
            "state": "MI",
            "license": "2901016846",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Chartyise Fagan, M.A., LPC
• Devonne Fagan
• Krista Fager
• Kimberly Fagg
• Caro R Fahle, MNT
• Fahoury, LLC
• Rania Fahoury, MD
• Tracey Fails
• Megan Gayle Fairbanks, LMT
• Chloe K Fairchild, M.A.

• Prosthodontics in Toledo, OH
• Providers in Toledo, OH by specialty
• Prosthodontics in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2011; 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.