Active NPI
Fairfax Dental Office PLLC
- Student Health Clinic/Center
- Fairfax, OK
National Provider Identifier
1992536478
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Student Health Clinic/Center
- Legal business name
- FAIRFAX DENTAL OFFICE PLLC
- Practice address
- 158 N 2ND St
Fairfax, OK 74637 - Phone
- (918) 642-3400
- NPI assigned
- Aug 8, 2024
- Last updated
- Nov 26, 2024
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Zane Grey Mills, DDS
- Title
- Dentist
- Phone
- (918) 642-3400
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dental Clinic/Center | 261QD0000X | |||
| Student Health Clinic/Center | 261QS1000X | Primary |
Addresses
Primary practice location
158 N 2ND St
Fairfax, OK 74637
Mailing address
158 N 2ND St
Fairfax, OK 74637
Phone (918) 642-3400
National Provider Directory
National Provider DirectoryPractitioners & 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.
-
- General Practice Dentistry
- Fairfax, OK
- NPI 1134978596
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1723075200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1732579200000",
"number": "1992536478",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "158 N 2ND ST",
"city": "FAIRFAX",
"state": "OK",
"postal_code": "74637",
"telephone_number": "918-642-3400"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "158 N 2ND ST",
"city": "FAIRFAX",
"state": "OK",
"postal_code": "74637",
"telephone_number": "918-642-3400"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "FAIRFAX DENTAL OFFICE PLLC",
"organizational_subpart": "NO",
"enumeration_date": "2024-08-08",
"last_updated": "2024-11-26",
"certification_date": "2024-11-25",
"status": "A",
"authorized_official_last_name": "MILLS",
"authorized_official_first_name": "ZANE",
"authorized_official_middle_name": "GREY",
"authorized_official_title_or_position": "DENTIST",
"authorized_official_telephone_number": "918-642-3400",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "DDS"
},
"taxonomies": [
{
"code": "261QD0000X",
"taxonomy_group": "",
"desc": "Clinic/Center, Dental",
"state": null,
"license": null,
"primary": false
},
{
"code": "261QS1000X",
"taxonomy_group": "",
"desc": "Clinic/Center, Student Health",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fairfax, OK
- Cah Acquisition Company 12 LLC (Fairfax Community Hospital)
- Cah Acquisition Company 12 LLC (Fairfax Rural Health Clinic)
- Leslie C Christopher, DDS
- Deanna J. Cummings, PA-C
- Fairfax Behavioral Health and Memory Care Community, LLC
- Fairfax Healthcare Properties, LLC (Fairfax Home Health)
- Fairfax Healthcare Properties,L.L.C. (Fairfax Memorial Hospital)
- Fairfax Healthcare Properties,LLC (Fairfax Memorial Hospital)
- Fairfax Medical Facilities Inc (Robert Clark Family Health Center)
- Fairfax Pharmacy LLC (OGM Investments)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 26, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.