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Deactivated NPI 1710077920 Deactivated / Inactive NPI Male Practitioner

Dr. Thomas Michael Fake , DDS

Dentist - General Practice • Denison, IA

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Dr. Thomas Fake has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date October 16, 2006
NPI Deactivation Date July 26, 2023
Total Practice Duration ~17 Years of Practice (2006 – 2023)

Professional Overview & Biography Verified Profile Summary

Dr. Thomas Fake, DDS was a registered Dentist - General Practice practicing in Denison, IA. Throughout an active medical career spanning 17 years, Dr. Fake provided care at the practice location at 113 N 14TH ST until profile deactivation on 2023-07-26.

Practice Location & Contact Primary Location

Practice Address

113 N 14th St

Denison, IA 514421452

Telephone 7122635172
Fax 7122634546

Specialty Benchmarks & Practice Insights

Comparative analytics for Dentist - General Practice in Denison, IA

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 9.0 Yrs
Regional Practice Density
6 Specialists

Practicing in Denison, IA (1303 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Dentist - General Practice Primary Specialty

NUCC Taxonomy Code: 1223G0001X

State License IA 5562

A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events
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NPI Profile Deactivated July 26, 2023

Record deactivated on July 26, 2023

NPI Profile Active July 08, 2007

NPI status registered as active in NPPES database

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Updated Practice Location July 08, 2007

Registered at 113 N 14TH ST, DENISON, IA 514421452 (Tel: 7122635172)

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Updated Business Mailing Address July 08, 2007

Registered at 2620 WESTCOTT RD, DENISON, IA 514427626 (Tel: 7122635172)

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Provider Name / Credentials Updated July 08, 2007

Recorded as THOMAS FAKE, D.D.S.

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Medical Taxonomy / Specialty Registered (Primary Specialty) July 08, 2007

Dentist (License #5562 in IA)

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Initial NPI Registration & Enumeration October 16, 2006

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1710077920
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: October 16, 2006
Last Update: July 08, 2007
Deactivation Date: July 26, 2023

Mailing Address

2620 Westcott Rd

Denison, IA 514427626

Phone: 7122635172

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.