Nicholas a. Fredericka D.M.D. Inc.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

30016140 Issued in OH

Legal business name

NICHOLAS A. FREDERICKA D.M.D. INC.

Practice address

822 Robbins Ave
Niles, OH 44446-2432

Phone

(330) 652-6500

Fax

(330) 652-6550

NPI assigned

Apr 24, 2007

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Nicholas Anthony Fredericka, D.M.DNPI 1790904589

Title

President

Phone

(330) 652-6500

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Nicholas Anthony Fredericka, D.M.D

  • General Practice Dentistry
  • Yerington, NV
  • NPI 1790904589
  NPD (past) Authorized official

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

{
    "created_epoch": "1177372800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1013136746",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "822 ROBBINS AVE",
            "city": "NILES",
            "state": "OH",
            "postal_code": "444462432",
            "telephone_number": "330-652-6500",
            "fax_number": "330-652-6550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "822 ROBBINS AVE",
            "city": "NILES",
            "state": "OH",
            "postal_code": "444462432",
            "telephone_number": "330-652-6500",
            "fax_number": "330-652-6550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NICHOLAS A. FREDERICKA D.M.D. INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-24",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "FREDERICKA",
        "authorized_official_first_name": "NICHOLAS",
        "authorized_official_middle_name": "ANTHONY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "330-652-6500",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.M.D"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "OH",
            "license": "30016140",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lindsey Nestor
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• Brittany Newman
• Kerri Newman
• Roxann Nicholas
• Ashlee Nicole
• Niles Center for Sight LLC
• Niles Center for Sight LLC (Eyewear Center for Sight)
• Niles City Schools

• General Practice Dentistry in Niles, OH
• Providers in Niles, OH by specialty
• General Practice Dentistry in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.