Henry Doloso Fajardo, D.M.D.

Primary specialty

DentistTaxonomy code 122300000X

License

45107 Issued in CA

Practice address

2100 E Clinton Ave
Fresno, CA 93703-2134

Phone

(559) 224-5988

Fax

(559) 224-5933

NPI assigned

Sep 28, 2006

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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

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

Medicare enrollment (NPD)

Enrolled

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.

• Henry D. Fajardo, D.M.D., Inc.

  • Dentist
  • Fresno, CA
  • NPI 1487065454
  NPD (past) Authorized official

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

{
    "created_epoch": "1159401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1548352685",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2100 E CLINTON AVE",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937032134",
            "telephone_number": "559-224-5988",
            "fax_number": "559-224-5933"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 E CLINTON AVE",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937032134",
            "telephone_number": "559-224-5988",
            "fax_number": "559-224-5933"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAJARDO",
        "first_name": "HENRY",
        "middle_name": "DOLOSO",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-28",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "45107",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "B45107-01",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Alexander Fair, DO
• Elise Marie Fairbanks
• Morigan Snow Fairbanks
• Troy Eugene Fairchild Jr., PHARMD
• Faithful Home Health Services
• Jacklyn Fajardo
• Marie V Fajardo, R.N., N.P
• Yuriel S Falcon Garcia
• Alyssa Lilia Falcon
• Anali Falcon

• Dentist in Fresno, CA
• Providers in Fresno, CA by specialty
• Dentist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.