NPIMap

Organization Active NPI

Fourth Dimension Orthodontics & Craniofacial Orthopedics, PLLC

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Corpus Christi, TX
National Provider Identifier
1295976082
Registry record updated Mar 9, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
License
21639 Issued in TX
Legal business name
FOURTH DIMENSION ORTHODONTICS & CRANIOFACIAL ORTHOPEDICS, PLLC
Practice address
7717 Outreau Dr
Corpus Christi, TX 78414-6148
Phone
(361) 985-0964
NPI assigned
Mar 9, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 9, 2009

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

Authorized official

Name
Dr. Deji V. Fashemo, DDS
Title
Member
Phone
(361) 985-0964

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthodontics and Dentofacial Orthopedics DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223X0400X 21639 TX Primary

Addresses

Primary practice location

7717 Outreau Dr
Corpus Christi, TX 78414-6148

Mailing address

7717 Outreau Dr
Corpus Christi, TX 78414-6148
Phone (361) 985-0964

National Provider Directory

National Provider Directory
Tax ID family
Fourth Dimension Orthodontics Craniofacial Orthopedics2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1236556800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1236556800000",
    "number": "1295976082",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7717 OUTREAU DR",
            "city": "CORPUS CHRISTI",
            "state": "TX",
            "postal_code": "784146148",
            "telephone_number": "361-985-0964"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7717 OUTREAU DR",
            "city": "CORPUS CHRISTI",
            "state": "TX",
            "postal_code": "784146148",
            "telephone_number": "361-985-0964"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOURTH DIMENSION ORTHODONTICS & CRANIOFACIAL ORTHOPEDICS, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-03-09",
        "last_updated": "2009-03-09",
        "status": "A",
        "authorized_official_last_name": "FASHEMO",
        "authorized_official_first_name": "DEJI",
        "authorized_official_middle_name": "V.",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "361-985-0964",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "TX",
            "license": "21639",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Corpus Christi, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2009; 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.