Paul a. Fredrikson, D.D.S., P.C.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

1504 Issued in ND

Legal business name

PAUL A. FREDRIKSON, D.D.S., P.C.

Practice address

3011 25TH St S
Suite 1
Fargo, ND 58103-6162

Phone

(701) 280-0088

Fax

(701) 293-5602

NPI assigned

Dec 31, 2013

Organization subpart

No

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

Authorized official

Name

Paul A Fredrikson, D.D.S., PC

Title

President

Phone

(701) 280-0088

Specialties & licenses 1

Addresses

Other identifiers 1

Tax ID family

Paul a Fredrikson DDS PC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Smile Care

  • Dentist
  • Fargo, ND
  • NPI 1457074882
  NPD tax ID

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Ryan Scott Nygard

  • General Practice Dentistry
  • Fargo, ND
  • NPI 1881075257
  NPD (past)

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

{
    "created_epoch": "1388448000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1388966400000",
    "number": "1003237512",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3011 25TH ST S",
            "address_2": "SUITE 1",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581036162",
            "telephone_number": "701-280-0088",
            "fax_number": "701-293-5602"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3011 25TH ST S",
            "address_2": "SUITE 1",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581036162",
            "telephone_number": "701-280-0088",
            "fax_number": "701-293-5602"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PAUL A. FREDRIKSON, D.D.S., P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-12-31",
        "last_updated": "2014-01-06",
        "status": "A",
        "authorized_official_last_name": "FREDRIKSON",
        "authorized_official_first_name": "PAUL",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "701-280-0088",
        "authorized_official_credential": "D.D.S., PC"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "ND",
            "license": "1504",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "40631",
            "state": "ND"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lakshmi Kant Pathak, MD
• Patricia Bathie Counseling
• Annie Patta, MD
• Michelle Joy Pattengale, MLS
• Brenda Joan Patzner, M.S., CCC-SLP
• Navin Paul, M.D.
• Ashlea Anna Paulsen
• Amanda Paulson, CRNA
• Paulvital Wellness
• Amanda Rae Pauna

• General Practice Dentistry in Fargo, ND
• Providers in Fargo, ND by specialty
• General Practice Dentistry in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2014; 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.