NPIMap

Organization Active NPI

Fangman Oral and Facial Surgery Professional LLC

  • Oral and Maxillofacial Surgery (Dentist)
  • Denver, CO
National Provider Identifier
1952791964
Registry record updated Feb 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
202239 Issued in CO
Legal business name
FANGMAN ORAL AND FACIAL SURGERY PROFESSIONAL LLC
Practice address
1440 Blake St Ste 100
Denver, CO 80202-1475
Phone
(720) 328-4990
Fax
(720) 328-4994
NPI assigned
Jan 28, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 8, 2022

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

Authorized official

Name
Dr. Brian Fangman, DDS
Title
Oral Maxillofacial Surgeon/Owner
Phone
(720) 328-4990

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist)Group: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223S0112X 202239 CO Primary

Addresses

Primary practice location

1440 Blake St Ste 100
Denver, CO 80202-1475

Mailing address

1440 Blake St Ste 100
Denver, CO 80202-1475
Phone (720) 328-4990

Other names 1

  • Altitude Oral Maxillofacial Implant Center Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Fangman Oral and Facial Surgery Professional LLC5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

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

NPI Registry JSON

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

{
    "created_epoch": "1422403200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1644278400000",
    "number": "1952791964",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1440 BLAKE ST STE 100",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802021475",
            "telephone_number": "720-328-4990",
            "fax_number": "720-328-4994"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1440 BLAKE ST STE 100",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802021475",
            "telephone_number": "720-328-4990",
            "fax_number": "720-328-4994"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FANGMAN ORAL AND FACIAL SURGERY PROFESSIONAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-01-28",
        "last_updated": "2022-02-08",
        "certification_date": "2022-02-08",
        "status": "A",
        "authorized_official_last_name": "FANGMAN",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_title_or_position": "ORAL MAXILLOFACIAL SURGEON/OWNER",
        "authorized_official_telephone_number": "720-328-4990",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "CO",
            "license": "202239",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Altitude Oral Maxillofacial Implant Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Denver, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2022; 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.