Marco Tulio Fajardo Jr., D.D.S.

Primary specialty

DentistTaxonomy code 122300000X

License

019-023251 Issued in IL

Practice address

380 W Diehl Rd
Naperville, IL 60563-1277

Phone

(630) 393-3045

Fax

(630) 393-3920

NPI assigned

Aug 30, 2006

Last updated

Feb 15, 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

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• West Suburban Oral Health Care

  • Dental Clinic/Center
  • Naperville, IL
  • NPI 1902915986
  NPD

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1676419200000",
    "number": "1841309929",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "340 TUPELO AVE",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605407828",
            "telephone_number": "630-327-9295"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "380 W DIEHL RD",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605631277",
            "telephone_number": "630-393-3045",
            "fax_number": "630-393-3920"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAJARDO",
        "first_name": "MARCO",
        "middle_name": "TULIO",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-30",
        "last_updated": "2023-02-15",
        "certification_date": "2023-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": "019-023251",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Abigail Faber, DCLINPSY
• Kristina Fabis, FNP-BC
• Briana Faille
• Scott Alan Faith, DVM
• Faithful Wellness, LLC
• Stephen Fako, DDS
• Bejan J Fakouri, MD
• Falcon Perspective P.C. (Sokol Counseling Solutions)
• Falguni Vasa MD SC
• Fall Prevention Services, LLC (Fal Prevention Clinics of America)

• Dentist in Naperville, IL
• Providers in Naperville, IL by specialty
• Dentist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 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.