Joshua Abrams Fair, DDS
Individual provider Active NPI General Practice Dentistry · Fremont, MI
NPI 1306005129 · NPPES record last updated May 28, 2020
Key facts
- NPI
- 1306005129
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Dentistry 1223G0001X
- License
- 2901021109 (MI)
- Practice address
- 517 N Stone Rd Ste 102
Fremont, MI 49412-8629 - Phone
- (231) 924-5542
- NPI assigned
- Jun 6, 2008
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 3
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MI
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160321001893 | MI | Order and Referring Only - Oral Surgery |
2668779505 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 019-028925 | IL | MD | General Practice Dentistry |
| 2901021109 | MI | MD | General Practice Dentistry |
| 6481-15 | WI | MD | General Practice Dentistry |
| 14214 | MD | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| DRS Fair and Niquette PC | Past |
Accepting new patients | |
| DRS Taggart and Niquette P C | General Practice | Past | Accepting new patients |
| Geers Family Chiropractic LLC | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 019-028925 | IL | |
| General Practice Dentistry | 1223G0001X | 14214 | MD | |
| General Practice Dentistry | 1223G0001X | 6481-15 | WI | |
| General Practice Dentistry | 1223G0001X | 2901021109 | MI | Yes |
Addresses
Primary practice location
517 N Stone Rd Ste 102
Fremont, MI 49412-8629
Mailing address
517 N Stone Rd Ste 102
Fremont, MI 49412-8629
Phone (231) 924-5542
Other providers in Fremont, MI
- Charles Gerard Emond Jr.
- Jehanna Shaelah Erho
- Charles Merle Erickson
- Joni Lynn Erlewein
- Aaron Michael Evans
- Anna Falconburg
- Family & Life Counseling
- Gerald Lee Fedelem
- Jeanne Louise Feikema
- Megan Marie Folkema
All providers in Fremont, MI · General Practice Dentistry in Michigan
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 28, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.