Omolara M Fadare, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

24257 Issued in TX

Practice address

812 Chestnut St
Bastrop, TX 78602-3205

Phone

(512) 985-7535

NPI assigned

Sep 11, 2008

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Main Street

  • Dental Clinic/Center
  • Bastrop, TX
  • NPI 1710561824
  NPD
• Tremont Road Dental Super, P.C.

  • General Practice Dentistry
  • Falls Church, VA
  • NPI 1366539959
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1221091200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723593600000",
    "number": "1063661361",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8001 E WILLIAM CANNON DR APT 4311",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787448330",
            "telephone_number": "319-621-6293"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "812 CHESTNUT ST",
            "city": "BASTROP",
            "state": "TX",
            "postal_code": "786023205",
            "telephone_number": "512-985-7535"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FADARE",
        "first_name": "OMOLARA",
        "middle_name": "M",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-09-11",
        "last_updated": "2024-08-14",
        "certification_date": "2024-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "24257",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Timothy Engman
• Troy Alonzo Enis Jr.
• Daniel Esteban, O.D.
• Jeffrey Evans, LPC
• Eve Barton, M.Ed., LPC, LLC
• Family Health Center of Bastrop PLLC
• Alyssa Nicole Fanella, PA-C
• Susan Lynn Farris, LCSW
• Fast Track Urgent Care
• Fast Track Urgent Care - Bastrop

• General Practice Dentistry in Bastrop, TX
• Providers in Bastrop, TX by specialty
• General Practice Dentistry in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.