Randy J Fagan is a Dentist in Broken Arrow, Oklahoma. Randy J Fagan practices all healthcare services and medical treatments related to Dentist. The NPI Number for Randy J Fagan is 1487628731. The last update date is 2007-07-08.
Randy J Fagan's current location address is 2221 W Washington St, Broken Arrow, Oklahoma. You can contact this provider via phone number 9184556406 and fax number 9184551856. The mailing address for Randy J Fagan is 2221 W Washington St, Broken Arrow, Oklahoma. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Randy J Fagan |
|---|---|
| Address | 2221 W Washington St, Broken Arrow, Oklahoma |
| Phone Number | 9184556406 |
| Fax Number | 9184551856 |
| Sole Proprietor | X |
| Credentials | DDS |
NPI Number Detail
| NPI Number | 1487628731 |
|---|---|
| Provider Enumeration Date | 2006-02-14 |
| Last Updated Date | 2007-07-08 |
Provider Mailing Address Detail
| Address | 2221 W Washington St |
|---|---|
| City | Broken Arrow |
| State | Oklahoma (OK) |
| Post Code | 740126726 |
| Phone Number | 9184556406 |
| Fax Number | 9184551856 |
Provider's Primary Taxonomy Detail
| Speciality | Dentist |
|---|---|
| Taxonomy | 122300000X |
| Licence No | 5318 |
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Definition: A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: denti |
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What is the unique 10-digit identification code issued to Randy J Fagan by the Centers for Medicare & Medicaid Services?
The Randy J Fagan has been assigned the NPI (National Provider Identifier) 1487628731 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code serves as a unique identifier for healthcare providers.
Could you please provide the complete street address where Randy J Fagan is physically located?
The Randy J Fagan is physically situated at the following address: 2221 W Washington St, Broken Arrow, OK, 740126726.
What is Randy J Fagan's area of expertise and its corresponding taxonomy classification?
The Randy J Fagan's field of specialization is Dentist, and it falls under the taxonomy code 122300000X, which categorizes healthcare providers based on their areas of practice.
On what date did the Centers for Medicare & Medicaid Services assign the 1487628731 to Randy J Fagan?
The Centers for Medicare & Medicaid Services assigned the 1487628731 to Randy J Fagan on 2006-02-14.
As of what date were the details related to Randy J Fagan most recently updated or revised?
The information pertaining to Randy J Fagan, including its address, specialty, and other relevant details, was last updated or revised on 2007-07-08.
NPI Number: 1215930425
Address: 224 W Exchange St, Akron, OH