NPIMap

Organization Active NPI

Bashar W. Fargo, DDS, Inc.

  • Dental Clinic/Center
  • Fontana, CA
National Provider Identifier
1104466598
Registry record updated Jan 14, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
Legal business name
BASHAR W. FARGO, DDS, INC.
Practice address
8275 Sierra Ave Ste 102
Fontana, CA 92335-3557
Phone
(951) 640-5013
NPI assigned
Jan 14, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 14, 2020

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

Authorized official

Name
Bashar Fargo, DDSNPI 1154845345
Title
Dentist/Owner
Phone
(951) 640-5013

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X Primary

Addresses

Primary practice location

8275 Sierra Ave Ste 102
Fontana, CA 92335-3557

Mailing address

1621 Liv CT
Redlands, CA 92374-2718

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1578960000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1578960000000",
    "number": "1104466598",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1621 LIV CT",
            "city": "REDLANDS",
            "state": "CA",
            "postal_code": "923742718"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8275 SIERRA AVE STE 102",
            "city": "FONTANA",
            "state": "CA",
            "postal_code": "923353557",
            "telephone_number": "951-640-5013"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BASHAR W. FARGO, DDS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-01-14",
        "last_updated": "2020-01-14",
        "certification_date": "2020-01-14",
        "status": "A",
        "authorized_official_last_name": "FARGO",
        "authorized_official_first_name": "BASHAR",
        "authorized_official_title_or_position": "DENTIST/OWNER",
        "authorized_official_telephone_number": "951-640-5013",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fontana, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2020; 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.