Active NPI
Robert Harris Friedman, D.M.D.
- Dentist
- Callahan, FL
National Provider Identifier
1003819657
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- DN10749
- Practice address
- 450031 State Road 200
Callahan, FL 32011-3847 - Phone
- (904) 879-1893
- NPI assigned
- May 27, 2005
- Last updated
- Oct 17, 2023
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | DN10749 | FL | Primary |
| General Practice Dentistry | 1223G0001X | 10749 | FL |
Addresses
Primary practice location
450031 State Road 200
Callahan, FL 32011-3847
Mailing address
86175 Meadowfield Bluffs Rd
Yulee, FL 32097-8412
Phone (904) 556-4692
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20150123000336 | FL | Order and Referring Only - Oral Surgery | 6507180437 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 10749 | FL | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sage Dental of Callahan PLLC | Dentist | Current | Accepting new patients |
| Amelia Perfect Smiles | Dentist | Current | Accepting new patients |
| Ad34 Florida P.a | Dentist | Past | Accepting new patients |
| Professional Dental Alliance of Fernandina Beach, PLLC | General Practice | Past | Accepting new patients |
Locations
450031 State Road 200
Callahan, FL 32011
Phone (904) 879-1893
Networks
- FL HMO D-SNP
- devoted network organization-84bf27aa-506a-49c4-8818-702cf5e8efb3
- FL HMO C-SNP
Organizations & group practices 4
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.
-
- Dentist
- Fernandina Beach, FL
- NPI 1437003258
-
- Dentist
- Callahan, FL
- NPI 1053191742
-
- Dentist
- Fernandina Beach, FL
- NPI 1568900785
-
- General Practice Dentistry
- Fernandina, FL
- NPI 1740810951
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1117152000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1697500800000",
"number": "1003819657",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "86175 MEADOWFIELD BLUFFS RD",
"city": "YULEE",
"state": "FL",
"postal_code": "320978412",
"telephone_number": "904-556-4692",
"fax_number": "904-261-8181"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "450031 STATE ROAD 200",
"city": "CALLAHAN",
"state": "FL",
"postal_code": "320113847",
"telephone_number": "904-879-1893"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FRIEDMAN",
"first_name": "ROBERT",
"middle_name": "HARRIS",
"name_prefix": "Dr.",
"credential": "D.M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-05-27",
"last_updated": "2023-10-17",
"certification_date": "2023-10-17",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "FL",
"license": "DN10749",
"primary": true
},
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "FL",
"license": "10749",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Callahan, FL
- Asteria A Ferrer, MD
- Robert M Frankle, M.D.
- James Jackson Freeland Jr., LCSW
- Friedman & Greenhut DPM PA (Callahan Foot & Ankle Clinic)
- Michael L Friedman, DPM
- William Patrick Gaffigan III, PT, DPT
- Robert Ethan Gentry, PHARMD
- Janet Byrd Gilbert, ARNP
- Great Strides Rehabilitation Inc.
- Great Strides Rehabilitation Inc.
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2023; 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.