Provider Demographics
NPI:1275504953
Name:FAERBER, JOHN S (DDS PA)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:S
Last Name:FAERBER
Suffix:
Gender:M
Credentials:DDS PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4121 W 83RD STREET
Mailing Address - Street 2:SUITE 245
Mailing Address - City:PRAIRIE VILLAGE
Mailing Address - State:KS
Mailing Address - Zip Code:66208
Mailing Address - Country:US
Mailing Address - Phone:913-648-6694
Mailing Address - Fax:913-648-6697
Practice Address - Street 1:4121 W 83RD ST
Practice Address - Street 2:SUITE 245
Practice Address - City:PRAIRIE VILLAGE
Practice Address - State:KS
Practice Address - Zip Code:66208-5300
Practice Address - Country:US
Practice Address - Phone:913-648-6694
Practice Address - Fax:913-648-6697
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS5880122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist