Active NPI
Jonathan Elliot Fryml, DMD
- Pediatric Dentistry
- Greer, SC
National Provider Identifier
1013442078
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Dentistry
- License
- 2021
- Practice address
- 318 Memorial Dr
Greer, SC 29650-1521 - Phone
- (864) 416-7880
- Fax
- (864) 416-7808
- NPI assigned
- Apr 27, 2017
- Last updated
- May 17, 2022
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 33481 | TX | |
| Pediatric Dentistry | 1223P0221X | 2021 | SC | Primary |
| Student in an Organized Health Care Education/Training Program | 390200000X |
Addresses
Primary practice location
318 Memorial Dr
Greer, SC 29650-1521
Mailing address
318 Memorial Dr
Greer, SC 29650-1521
Phone (864) 416-7880
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 33481 | TX | MD | General Practice Dentistry |
| 2021 | SC | MD | Physical Therapy Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mountain View Pediatric Dentistry, LLC | Pediatric Dentistry | Current | Accepting new patients |
| Mountain View Pediatric Dentistry, LLC | Pediatric Dentistry | Current | Accepting new patients |
Locations
318 Memorial Dr
Greer, SC 29650
Phone (864) 416-7880
Organizations & group practices 2
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.
-
- Pediatric Dentistry
- Greer, SC
- NPI 1346828753
-
dba Mountain View Pediatric Dentistry
- Pediatric Dentistry
- Greer, SC
- NPI 1487312526
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1493251200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1652745600000",
"number": "1013442078",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "318 MEMORIAL DR",
"city": "GREER",
"state": "SC",
"postal_code": "296501521",
"telephone_number": "864-416-7880",
"fax_number": "864-416-7808"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "318 MEMORIAL DR",
"city": "GREER",
"state": "SC",
"postal_code": "296501521",
"telephone_number": "864-416-7880",
"fax_number": "864-416-7808"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FRYML",
"first_name": "JONATHAN",
"middle_name": "ELLIOT",
"credential": "DMD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2017-04-27",
"last_updated": "2022-05-17",
"certification_date": "2022-05-17",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "TX",
"license": "33481",
"primary": false
},
{
"code": "1223P0221X",
"taxonomy_group": "",
"desc": "Dentist, Pediatric Dentistry",
"state": "SC",
"license": "2021",
"primary": true
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Greer, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.