Fair Oaks Orthodontics

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

58043 Issued in CA

Legal business name

FAIR OAKS ORTHODONTICS

Practice address

1318 Fair Oaks Ave
Suite a
South Pasadena, CA 91030-3808

Phone

(626) 795-5978

Fax

(626) 796-1173

NPI assigned

Feb 7, 2017

Organization subpart

No

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

Authorized official

Name

Sharon Bradley

Title

Insurance Coordinator

Phone

(626) 795-5978

Specialties & licenses 2

Addresses

Locations

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

{
    "created_epoch": "1486425600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1486425600000",
    "number": "1811435092",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1318 FAIR OAKS AVE",
            "address_2": "SUITE A",
            "city": "SOUTH PASADENA",
            "state": "CA",
            "postal_code": "910303808",
            "telephone_number": "626-795-5978",
            "fax_number": "626-796-1173"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1318 FAIR OAKS AVE",
            "address_2": "SUITE A",
            "city": "SOUTH PASADENA",
            "state": "CA",
            "postal_code": "910303808",
            "telephone_number": "626-795-5978",
            "fax_number": "626-796-1173"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAIR OAKS ORTHODONTICS",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-02-07",
        "last_updated": "2017-02-07",
        "status": "A",
        "authorized_official_last_name": "BRADLEY",
        "authorized_official_first_name": "SHARON",
        "authorized_official_title_or_position": "INSURANCE COORDINATOR",
        "authorized_official_telephone_number": "626-795-5978"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "CA",
            "license": "58043",
            "primary": true
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "CA",
            "license": "55726",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stephanie Estephan
• Sonia I. Estratalan, M.A.
• Otto R Evans II
• Josephine Molina Factora, B.A
• Gerry Fagoaga, MFT
• Far East Holistic Health Care Center Inc
• Alayne Maria Faraone
• Kaniz Fatema
• Julia Wexler Feil
• Chelsea Feller

• Orthodontics and Dentofacial Orthopedics Dentistry in South Pasadena, CA
• Providers in South Pasadena, CA by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2017; 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.