Individual provider Active NPI

Joshua Abrams Fair, DDS

  • General Practice Dentistry
  • Fremont, MI
National Provider Identifier
1306005129
Registry record updated May 28, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
2901021109 Issued in MI
Practice address
517 N Stone Rd Ste 102
Fremont, MI 49412-8629
Phone
(231) 924-5542
NPI assigned
Jun 6, 2008
Last updated
May 28, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 28, 2020

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
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 Primary

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

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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

Enrollment IDStateProvider typePAC IDDetails
I20160321001893 MI Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 2668779505

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
019-028925ILMDGeneral Practice Dentistry
2901021109MIMDGeneral Practice Dentistry
6481-15WIMDGeneral Practice Dentistry
14214MDMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
DRS Taggart and Niquette P C General Practice Past Accepting new patients
Geers Family Chiropractic LLC PastSince Jan 4, 2010 Accepting new patients
DRS Fair and Niquette PC PastSince May 31, 2020 Accepting new patients

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1212710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1590624000000",
    "number": "1306005129",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "517 N STONE RD STE 102",
            "city": "FREMONT",
            "state": "MI",
            "postal_code": "494128629",
            "telephone_number": "231-924-5542",
            "fax_number": "231-924-5826"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "517 N STONE RD STE 102",
            "city": "FREMONT",
            "state": "MI",
            "postal_code": "494128629",
            "telephone_number": "231-924-5542"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAIR",
        "first_name": "JOSHUA",
        "middle_name": "ABRAMS",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-06-06",
        "last_updated": "2020-05-28",
        "certification_date": "2020-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019-028925",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MD",
            "license": "14214",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WI",
            "license": "6481-15",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "2901021109",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fremont, MI

Sources for this page

Verify at the official NPI Registry.