Blair Washburn Fadem, D.D.S.

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

39399 Issued in CA

Practice address

735 E Ohio Ave Ste 202
Escondido, CA 92025-3437

Phone

(760) 294-7450

Fax

(760) 294-7450

NPI assigned

Dec 7, 2006

Last updated

Apr 16, 2013By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Southern Indian Health Council

  • Health Service Clinic/Center
  • Campo, CA
  • NPI 1922090885
  NPD (past)

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

{
    "created_epoch": "1165449600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1366070400000",
    "number": "1912066713",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "735 E OHIO AVE",
            "address_2": "SUITE #202",
            "city": "ESCONDIDO",
            "state": "CA",
            "postal_code": "920253437",
            "telephone_number": "760-294-7450",
            "fax_number": "760-294-7450"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "735 E OHIO AVE STE 202",
            "city": "ESCONDIDO",
            "state": "CA",
            "postal_code": "920253437",
            "telephone_number": "760-294-7450",
            "fax_number": "760-294-7450"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FADEM",
        "first_name": "BLAIR",
        "middle_name": "WASHBURN",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-07",
        "last_updated": "2013-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "CA",
            "license": "39399",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Exodus Recovery, Inc.
• Eye Specialists of California Medical Group (Escondido Optical)
• Eye Specialists of California Medical Group (Escondido Optical)
• F.I.R.E. Igniting Lives Psychology
• Randy Lee Faber, RDAT1
• Pamela Eva Fadul, M.D.
• Rhyl Ann Fenequito Faeldonea-Seruelo, M.D.
• Michelle Faierman, MD
• Fair Care Hospice Inc
• Briana Falcon

• Orthodontics and Dentofacial Orthopedics Dentistry in Escondido, CA
• Providers in Escondido, 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 Apr 16, 2013; 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.