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Mark Fagan, DDS
NPI 1588612790 · Prosthodontics · Fort Drum, NY
Mark Fagan, DDS is a Prosthodontics provider in Fort Drum, NY (NPI 1588612790).
Provider details
- NPI number
- 1588612790
- Entity type
- Individual
- Primary specialty
- ProsthodonticsDental Providers
- Credential
- DDS
- Sex
- Male
- Sole proprietor
- No
- License
- 11964 (MD)
Specialties & taxonomies
Dental Providers
Profile Score
Detailed profile(91/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
20 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
10205 N Riva Ridge Loop
Fort Drum, NY 13602-5457
Phone: (315) 772-5088
Street-level locationGet directions
Mailing address
120 Mill Creek Ln
Sackets Harbor, NY 13685-9744
Registry dates
- Enumerated
- 2006-05-04
- Last updated
- 2026-04-27
- Certified
- 2026-04-27
Frequently asked questions
- What is Mark Fagan's NPI number?
- Mark Fagan's National Provider Identifier (NPI) is 1588612790, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What is Mark Fagan's specialty?
- Mark Fagan is listed in the NPPES registry with a primary specialty of Prosthodontics (Dental Providers).
- Where is Mark Fagan located?
- Mark Fagan's practice location on file with NPPES is 10205 N Riva Ridge Loop, Fort Drum, NY 13602-5457.
- What is Mark Fagan's phone number?
- The practice phone number listed in the NPPES registry for Mark Fagan is (315) 772-5088.
- Is Mark Fagan's NPI active?
- Yes — Mark Fagan's NPI (1588612790) is active in the NPPES registry as of the last update on 2026-04-27.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.