Active NPI
Trudy-Ann Nicole Frazer, DDS
- Pediatric Dentistry
- Douglasville, GA
National Provider Identifier
1043655038
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Dentistry
- License
- DN014971
- Practice address
- 4020 Chapel Hill Rd
Douglasville, GA 30135-2829 - Phone
- (770) 949-2400
- NPI assigned
- May 3, 2013
- Last updated
- Apr 20, 2016
- Sex
- Female
- Sole proprietor
- No
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 | DN014971 | GA | Primary |
Addresses
Primary practice location
4020 Chapel Hill Rd
Douglasville, GA 30135-2829
Mailing address
4020 Chapel Hill Rd
Douglasville, GA 30135-2829
Phone (770) 949-2400
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in GA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20161021002193 | GA | Order and Referring Only - Other (Non-Physician) | 9537447743 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| R & R Dental Specialists, PC | Pediatric Dentistry | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Oral and Maxillofacial Surgery (Dentist)
- Douglasville, GA
- NPI 1336718212
Pediatric Dentistry
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1367539200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1461110400000",
"number": "1043655038",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4020 CHAPEL HILL RD",
"city": "DOUGLASVILLE",
"state": "GA",
"postal_code": "301352829",
"telephone_number": "770-949-2400"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4020 CHAPEL HILL RD",
"city": "DOUGLASVILLE",
"state": "GA",
"postal_code": "301352829",
"telephone_number": "770-949-2400"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FRAZER",
"first_name": "TRUDY-ANN",
"middle_name": "NICOLE",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-05-03",
"last_updated": "2016-04-20",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0221X",
"taxonomy_group": "",
"desc": "Dentist, Pediatric Dentistry",
"state": "GA",
"license": "DN014971",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Douglasville, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.