Thao Fajardo, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DN17923 Issued in FL

Practice address

6735 Conroy Windermere Rd
Suite #202
Orlando, FL 32835-3565

Phone

(407) 910-1178

Fax

(407) 624-3724

NPI assigned

Jul 2, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Thao Mai Former name

Medicare fee-for-service enrollment

Enrolled in FL

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

State licenses

Practice roles

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.

• Universal Smiles Dentistry PA

  • Dental Clinic/Center
  • Orlando, FL
  • NPI 1578999462
  NPD (past)

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

{
    "created_epoch": "1183334400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1379462400000",
    "number": "1295932184",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4433 BLUE MAJOR DR",
            "city": "WINDERMERE",
            "state": "FL",
            "postal_code": "347863192"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6735 CONROY WINDERMERE RD",
            "address_2": "SUITE #202",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328353565",
            "telephone_number": "407-910-1178",
            "fax_number": "407-624-3724"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAJARDO",
        "first_name": "THAO",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-07-02",
        "last_updated": "2013-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN17923",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "THAO",
            "last_name": "MAI",
            "credential": "DMD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Faithful Transport LLC
• Faithful Transportation Group Inc
• Claudia Fajardo
• Paula Fajardo
• Tessa Janaye Fajardo, CRNA
• Dania Fakhro
• Faisal Mohammad Fakih, DO
• Harun Fakioglu, MD
• Nadia Falah, MD, MSC
• Falasco Pediatrics

• General Practice Dentistry in Orlando, FL
• Providers in Orlando, 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 Sep 18, 2013; 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.