Healthcare Provider Details

I. General information

NPI: 1710807532
Provider Name (Legal Business Name): CHLOE LOVE FAIRMAN DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/20/2026
Last Update Date: 07/20/2026
Certification Date: 07/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9510 CUYAMACA ST STE 102
SANTEE CA
92071-2686
US

IV. Provider business mailing address

20420 VIA DEL PALMAR
YORBA LINDA CA
92886-4537
US

V. Phone/Fax

Practice location:
  • Phone: 619-449-6009
  • Fax:
Mailing address:
  • Phone: 714-336-1717
  • Fax: 714-336-1717

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number113487
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: