Joseph Derek Fridgen, DDS

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

50909 Issued in CA

Practice address

189 N Bascom Ave Ste 200
San Jose, CA 95128-1869

Phone

(408) 286-6315

Fax

(408) 286-6319

NPI assigned

Nov 20, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

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

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

{
    "created_epoch": "1163980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1003980194",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "189 N BASCOM AVE STE 200",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951281869",
            "telephone_number": "408-286-6315",
            "fax_number": "408-286-6319"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "189 N BASCOM AVE STE 200",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951281869",
            "telephone_number": "408-286-6315",
            "fax_number": "408-286-6319"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRIDGEN",
        "first_name": "JOSEPH",
        "middle_name": "DEREK",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "CA",
            "license": "50909",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jessica Lynn Frenette
• Hilary Genise Freund, DPT
• Cristina Freyer, LMFT
• Ariam Frezghi
• Guadalupe Friaz, MSW
• Jacqueline Friduss
• Sarah Fried
• Matthew Friedberg
• Miriam Hannah Friedland, MD
• Danielle Hanchett Friedman, LCSW

• Pediatric Dentistry in San Jose, CA
• Providers in San Jose, CA by specialty
• Pediatric Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.