Daisy Alicia Fatjo, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DN 18642 Issued in FL

Practice address

5138 Deer Park Dr
Suite #102
New Port Richey, FL 34653-7027

Phone

(727) 372-1481

Fax

(727) 372-1754

NPI assigned

Jul 23, 2009

Sex

Female

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

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

{
    "created_epoch": "1248307200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1385424000000",
    "number": "1861622839",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5138 DEER PARK DR",
            "address_2": "SUITE #102",
            "city": "NEW PORT RICHEY",
            "state": "FL",
            "postal_code": "346537027",
            "telephone_number": "727-372-1481",
            "fax_number": "727-372-1754"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5138 DEER PARK DR",
            "address_2": "SUITE #102",
            "city": "NEW PORT RICHEY",
            "state": "FL",
            "postal_code": "346537027",
            "telephone_number": "727-372-1481",
            "fax_number": "727-372-1754"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FATJO",
        "first_name": "DAISY",
        "middle_name": "ALICIA",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-07-23",
        "last_updated": "2013-11-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN 18642",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• General Practice Dentistry in New Port Richey, FL
• Providers in New Port Richey, FL by specialty
• General Practice Dentistry in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 26, 2013; 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.