Juan Jose Fajardo, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DN25194 Issued in FL

Practice address

4789 SW 148TH Ave Ste 205
Davie, FL 33330-2121

Phone

(954) 252-5911

NPI assigned

Jun 30, 2020

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Networks

• Freedom Health HMO Network

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.

• JB Oasis Dental PA

  • General Practice Dentistry
  • Pembroke Pines, FL
  • NPI 1528948619
  NPD Authorized official

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

{
    "created_epoch": "1593475200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1760054400000",
    "number": "1275150799",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4789 SW 148TH AVE STE 205",
            "city": "DAVIE",
            "state": "FL",
            "postal_code": "333302121",
            "telephone_number": "954-252-5911"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4789 SW 148TH AVE STE 205",
            "city": "DAVIE",
            "state": "FL",
            "postal_code": "333302121",
            "telephone_number": "954-252-5911"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10796 Pines Blvd Ste 203",
            "address_purpose": "LOCATION",
            "city": "Pembroke Pines",
            "state": "FL",
            "postal_code": "330263919",
            "country_code": "US",
            "telephone_number": "954-499-1599 x91599",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FAJARDO",
        "first_name": "JUAN",
        "middle_name": "JOSE",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-06-30",
        "last_updated": "2025-10-10",
        "certification_date": "2025-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN25194",
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "DRP2164",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• F & J Pharmacy, Inc
• Amyann Faced
• Portia Facen
• Yamilka Fagundo
• Alexandra Rose Failing
• Farima Fakheri Raof, PHARMD
• Laura Angela Falco, O.D.
• Joselin Falcon
• Shaion Falconer
• Murry Cuthbert Falkner III, OD

• General Practice Dentistry in Davie, FL
• Providers in Davie, FL by specialty
• General Practice Dentistry in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2025; 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.