Deji V. Fashemo, DDS, MPH

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

21639 Issued in TX

Practice address

7777 Forest LN
Suite # C-770
Dallas, TX 75230-2505

Phone

(972) 566-3100

Fax

(972) 566-3200

NPI assigned

May 18, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Fourth Dimension Orthodontics & Craniofacial Orthopedics

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Dallas, TX
  • NPI 1184946931
  NPD (past) Authorized official
• Children'S Physician Services of South Texas

  • Pediatrics Physician
  • Corpus Christi, TX
  • NPI 1801856786
  NPD (past)

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

{
    "created_epoch": "1147910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1257811200000",
    "number": "1457304412",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7777 FOREST LN",
            "address_2": "SUITE # C-770",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752302505",
            "telephone_number": "972-566-3100",
            "fax_number": "972-566-3200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7777 FOREST LN",
            "address_2": "SUITE # C-770",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752302505",
            "telephone_number": "972-566-3100",
            "fax_number": "972-566-3200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FASHEMO",
        "first_name": "DEJI",
        "middle_name": "V.",
        "credential": "DDS, MPH",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-18",
        "last_updated": "2009-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "TX",
            "license": "21639",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "171860301",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sherean Farvardin, M.D.
• Ali Farzad, M.D.
• Ramin Farzaneh-Far, M.D.
• Fas Ms Texas Physicians, P.a.
• Emmanuel Fasanya Jr., PT, DPT
• Olayemi Seidat Fashemo, NP
• Carlos G Fasola, M.D.
• Genevieve Fasolino, OTR, OTD
• Olamide T Fasonu, PHARM.D.
• Oren N Fass, M.D.

• Orthodontics and Dentofacial Orthopedics Dentistry in Dallas, TX
• Providers in Dallas, TX by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in Texas

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