Active NPI
Dale Frederick Fath, OD
- Optometrist
- Ft Wayne, IN
National Provider Identifier
1750358347
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 18001634A
- Practice address
- 7750 W Jefferson Blvd
Ft Wayne, IN 46804 - Phone
- (260) 459-9595
- Fax
- (260) 459-9494
- NPI assigned
- Mar 2, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 18001634A | IN | Primary |
Addresses
Primary practice location
7750 W Jefferson Blvd
Ft Wayne, IN 46804
Mailing address
7750 W Jefferson Blvd
Fort Wayne, IN 46804
Phone (260) 459-9595
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 18001634A | IN | MD | Optometrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1141257600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1750358347",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7750 W JEFFERSON BLVD",
"city": "FORT WAYNE",
"state": "IN",
"postal_code": "46804",
"telephone_number": "260-459-9595",
"fax_number": "260-459-9494"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7750 W JEFFERSON BLVD",
"city": "FT WAYNE",
"state": "IN",
"postal_code": "46804",
"telephone_number": "260-459-9595",
"fax_number": "260-459-9494"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FATH",
"first_name": "DALE",
"middle_name": "FREDERICK",
"credential": "OD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-03-02",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "IN",
"license": "18001634A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ft Wayne, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.