DR. TIM R FAGAN


Address: 1201 N Stonewall Ave, Oklahoma City, OK 73117-1214
Phone: 4052715444

DR. TIM R FAGAN (NPI# 1477557452) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1477557452
Entity Type Individual
Full Name DR. TIM R FAGAN
Credential DDS, MS
Practice Address 1201 N Stonewall Ave
Oklahoma City
OK 73117-1214
Mailing Address 423 N Van Buren St
Enid
OK 73703-4454
Practice Telephone 4052715444
Mailing Telephone 5802330043
Enumeration Date 2005-06-08
Last Update Date 2019-07-24
Gender Code M
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 1223P0221X Dentist
Specialization: Pediatric Dentistry
4227 OK Dental Providers

Provider Secondary Practice Location

Address Telephone Number Fax Number
423 N Van Buren St, Enid, OK 737034454 5802330043

Office Location

Street Address 1201 N STONEWALL AVE
City OKLAHOMA CITY
State OK
Zip Code 73117-1214

Providers in the same location

NPI Name Taxonomy Address Enumeration
1538778840 Allison Brewer Dinse Dentist 1201 N Stonewall Ave, Oklahoma City, OK 73117-1214 2020-07-23
1922625813 Amanda Stephanie Akkari Dentist 1201 N Stonewall Ave, Oklahoma City, OK 73117-1214 2020-06-26
1275159162 Katherine Ann Gamble Student in an Organized Health Care Education/Training Program 1201 N Stonewall Ave, Oklahoma City, OK 73117-1214 2020-06-17
1255957023 Andrew Lee Benjamin Jr. Student in an Organized Health Care Education/Training Program 1201 N Stonewall Ave, Oklahoma City, OK 73117-1214 2020-06-17
1295355337 Gabriel Duffy Student in an Organized Health Care Education/Training Program 1201 N Stonewall Ave, Oklahoma City, OK 73117-1214 2020-04-18
1558981829 Shawn Moffett Student in an Organized Health Care Education/Training Program 1201 N Stonewall Ave, Oklahoma City, OK 73117-1214 2020-04-16
1750933305 Schuyler Allison Pracht Dentist 1201 N Stonewall Ave, Oklahoma City, OK 73117-1214 2019-07-14
1801458385 Jeremiah Aigbedion Dentist 1201 N Stonewall Ave, Oklahoma City, OK 73117-1214 2019-07-03
1396307104 Kathleen Alexis Higgins Dentist 1201 N Stonewall Ave, Oklahoma City, OK 73117-1214 2019-07-01
1710548920 Cama Danielle Cord Dentist 1201 N Stonewall Ave, Oklahoma City, OK 73117-1214 2019-06-27
Find all providers in the same location

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1922623271 Katelyn Gerth Student in an Organized Health Care Education/Training Program University of Oklahoma College of Medicine, 800 Stanton L. Young Blvd, Oklahoma City, OK 73117 2020-06-12
1114401387 Northstar Counseling Associates, LLC Counselor 4540 E Reno Ave, Del City, OK 73117 2018-09-24
1801300710 Kenneth Belyeu Peer Specialist 625 N Nebraska, Okc, OK 73117 2017-11-30
1215483029 Brian Behnum Minavi Dentist 1201 N. Stonewall Ave., Oklahoma City, OK 73117 2016-08-31
1649631409 April Ajanwachukwu Social Worker 1309 N Nebraska Ave, Oklahoma City, OK 73117 2016-03-08
1518340405 Shachi Shah Dentist 1201 N Stonewall Ave # 544n, Oklahoma City, OK 73117 2015-07-09
1063829067 Lauren Marie Pierce Speech-Language Pathologist 1200 N. Stonewall Ave, Ahb 1058, Oklahoma City, OK 73117 2014-07-22
1306195235 Rachel Devecchio Case Manager/Care Coordinator 1300 Ne 13th St, Oklahoma City, OK 73117 2012-09-06
1265780837 Tiffany Dawn Stokely Counselor 1701 E Park Pl, Oklahoma, OK 73117 2012-08-29
1689935645 Everett House Behavioral Analyst 1100 Ne 15th St, Oklahoma Cituy, OK 73117 2012-06-06
Find all providers in zip 73117

Taxonomy Information

Taxonomy Code 1223P0221X
Grouping Dental Providers
Classification Dentist
Specialization Pediatric Dentistry

Taxonomy Definition

An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs.
Notes: Source: Council on Dental Education and Licensure, American Dental Association

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1932684297 Jemima Poitevien, D.d.s., P.l.l.c. Dentist 4225 W Memorial Rd Ste 101-b, Oklahoma City, OK 73134-1761 2018-10-02
1093062911 Pediatric Dental Partners Pllc Dentist 5940 Nw Expressway Ste 200, Oklahoma City, OK 73132-5101 2012-08-09
1508023383 Thai-an Doan D.d.s. P.C. Dentist 11318 N May Ave, Suite B, Oklahoma City, OK 73120-5860 2008-05-20
1619162054 Robert Brian Molloy Dentist 9801 S Pennsylvania Ave, Oklahoma City, OK 73159-6925 2007-09-10
1467574004 Smiling Faces Pediatric Dentistry Inc Dentist 5222 N. Portland, Oklahoma City, OK 73112 2007-04-04
1760521934 Elizabeth Kellner Dentist 828 Sw 66th St, Oklahoma City, OK 73139-4213 2007-02-05
1194828558 Thai-an Doan Dentist 14228 Barbour Ave, Oklahoma City, OK 73134 2006-09-07
1780618330 Andrew Cleveland Guthrie Dentist 3616 Nw 50th St, Oklahoma City, OK 73112-5642 2006-07-10
1558318493 Donald Wood Haskins Dentist 5222 N Portland Ave, Oklahoma City, OR 73112 2006-05-27
1720063225 William G Bozalis Dentist 3613 Nw 56th, Suite 105 Three Corporate Plaza, Oklahoma City, OK 73112 2005-12-07
Find all providers in OKLAHOMA CITY

Competitor

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City OKLAHOMA CITY
Zip Code 73117

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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