Alexander Russell Meade, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

103548 Issued in CA

Practice address

5041 Business Center Dr Ste 106
Fairfield, CA 94534-1787

Phone

(707) 863-9950

NPI assigned

Mar 16, 2018

Reactivated

Jul 18, 2018

Sex

Male

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

Enrolled in WA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

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.

• Mohan Bajwa DDS Inc

  • General Practice Dentistry
  • Fairfield, CA
  • NPI 1003760885
  NPD (past)

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

{
    "created_epoch": "1521158400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1637107200000",
    "number": "1073016820",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5041 BUSINESS CENTER DR STE 106",
            "city": "FAIRFIELD",
            "state": "CA",
            "postal_code": "945341787"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5041 BUSINESS CENTER DR STE 106",
            "city": "FAIRFIELD",
            "state": "CA",
            "postal_code": "945341787",
            "telephone_number": "707-863-9950"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEADE",
        "first_name": "ALEXANDER",
        "middle_name": "RUSSELL",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-03-16",
        "last_updated": "2021-11-17",
        "certification_date": "2021-11-17",
        "deactivation_date": "2018-07-02",
        "reactivation_date": "2018-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "103548",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shayla McNeal
• Kyle McNulty, DDS
• Anne McPheeters
• Wendy Michaela McStravick
• Dallas Omar McWilliams, IDMT
• Shahrzad Mease, LMFT
• Azucena Medina-Carrasco
• Josie Medina
• Manuel Amado Medina
• Maryfatima Medina

• Dentist in Fairfield, CA
• Providers in Fairfield, CA by specialty
• Dentist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.