Javier Alejandro Fonseca Paredes, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

DTP793 Issued in FL

Practice address

3300 S University Dr
Ft Lauderdale, FL 33328-2004

Phone

(954) 262-7213

Fax

(954) 262-7355

NPI assigned

Oct 10, 2023

Last updated

Oct 10, 2023By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1696896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696896000000",
    "number": "1306627880",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2721 SW 71ST TER APT 704",
            "city": "DAVIE",
            "state": "FL",
            "postal_code": "333141118",
            "telephone_number": "707-849-9037"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3300 S UNIVERSITY DR",
            "city": "FT LAUDERDALE",
            "state": "FL",
            "postal_code": "333282004",
            "telephone_number": "954-262-7213",
            "fax_number": "954-262-7355"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FONSECA PAREDES",
        "first_name": "JAVIER",
        "middle_name": "ALEJANDRO",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-10-10",
        "last_updated": "2023-10-10",
        "certification_date": "2023-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "DTP793",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2023; 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.