Active NPI
John Charles Frachella, DMD
- Pediatric Dentistry
- Redmond, OR
National Provider Identifier
1043360167
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Dentistry
- License
- D8841
- Practice address
- 1424 SW 15TH
Redmond, OR 47756 - Phone
- (406) 338-6182
- NPI assigned
- Jan 11, 2007
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Dentistry | 1223P0221X | D8841 | OR | Primary |
Addresses
Primary practice location
1424 SW 15TH
Redmond, OR 47756
Mailing address
PO Box 254
Mitchell, OR 97750-0254
Phone (541) 462-3055
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 |
|---|---|---|---|
| D8841 | OR | MD | Pediatric Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1168473600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1043360167",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 254",
"city": "MITCHELL",
"state": "OR",
"postal_code": "977500254",
"telephone_number": "541-462-3055"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1424 SW 15TH",
"city": "REDMOND",
"state": "OR",
"postal_code": "47756",
"telephone_number": "406-338-6182"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FRACHELLA",
"first_name": "JOHN",
"middle_name": "CHARLES",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-01-11",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0221X",
"taxonomy_group": "",
"desc": "Dentist, Pediatric Dentistry",
"state": "OR",
"license": "D8841",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Redmond, OR
Sources for this page
- 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.