Individual provider Active NPI

Robert Scott Fridlind, D.M.D.

  • General Practice Dentistry
  • Rancho Santa Margarita, CA
National Provider Identifier
1023054970
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
53146 Issued in CA
Practice address
22032 El Paseo
Suite 230
Rancho Santa Margarita, CA 92688-3947
Phone
(949) 888-0806
Fax
(949) 888-0199
NPI assigned
Jun 21, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 53146 CA Primary

Addresses

Primary practice location

22032 El Paseo
Suite 230
Rancho Santa Margarita, CA 92688-3947

Mailing address

34 Rue Fontaine
Foothill Ranch, CA 92610-2487
Phone (949) 351-1151

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160421002454 CT Order and Referring Only - DentistPractitioner - Dentist 3476852682

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
53146CAMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1150848000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1023054970",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "34 RUE FONTAINE",
            "city": "FOOTHILL RANCH",
            "state": "CA",
            "postal_code": "926102487",
            "telephone_number": "949-351-1151"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22032 EL PASEO",
            "address_2": "SUITE 230",
            "city": "RANCHO SANTA MARGARITA",
            "state": "CA",
            "postal_code": "926883947",
            "telephone_number": "949-888-0806",
            "fax_number": "949-888-0199"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRIDLIND",
        "first_name": "ROBERT",
        "middle_name": "SCOTT",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "53146",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rancho Santa Margarita, CA

Sources for this page

Verify at the official NPI Registry.