Nicholas a. Fredericka D.M.D. Inc.
Organization Active NPI General Practice Dentistry · Niles, OH
NPI 1013136746 · NPPES record last updated Aug 22, 2020
Key facts
- NPI
- 1013136746
- Entity type
- Organization (NPI type 2)
- Primary specialty
- General Practice Dentistry 1223G0001X
- License
- 30016140 (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
- Organization subpart
- No
Authorized official
- Name
- Dr. Nicholas Anthony Fredericka, D.M.D
- Title
- President
- Phone
- (330) 652-6500
Practitioners 1
-
Nicholas Anthony Fredericka, D.M.D
National Provider Directory
Locations
822 Robbins Ave
Niles, OH 44446
Phone (330) 652-6500
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry |
1223G0001X | 30016140 | OH | Yes |
Addresses
Primary practice location
822 Robbins Ave
Niles, OH 44446-2432
Mailing address
822 Robbins Ave
Niles, OH 44446-2432
Phone (330) 652-6500
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 196764 | Other | OH | UNITED CONCORDIA INS. ID# |
| 0493729 | Medicaid | OH |
Other providers in Niles, OH
- Lindsey Nestor
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- New Day Recovery, LLC
- Brittany Newman
- Kerri Newman
- Roxann Nicholas
- Ashlee Nicole
- Niles Center for Sight LLC
- Niles Center for Sight LLC
- Niles City Schools
All providers in Niles, OH · General Practice Dentistry in Ohio
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 22, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.