Fredericktown Family Dental

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

FREDERICKTOWN FAMILY DENTAL

Practice address

731 W Main St
Fredericktown, MO 63645-1113

Phone

(573) 783-4100

NPI assigned

Sep 15, 2015

Organization subpart

No

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

Authorized official

Name

John AdamsNPI 1881847531

Title

Owner

Phone

(573) 783-4100

Specialties & licenses 1

Addresses

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• John S. Adams, D.D.S.

  • General Practice Dentistry
  • Fredericktown, MO
  • NPI 1881847531
  NPD (past) Authorized official
• Linda Carole Cravens, RDN

  • Dentist
  • Fredericktown, MO
  • NPI 1679737324
  NPD (past)
• Gavin Bradley Messer, D.D.S.

  • Dentist
  • Mount Vernon, MO
  • NPI 1063471373
  NPD (past)

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

{
    "created_epoch": "1442275200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1442361600000",
    "number": "1043689557",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "731 W MAIN ST",
            "city": "FREDERICKTOWN",
            "state": "MO",
            "postal_code": "636451113",
            "telephone_number": "573-783-4100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "731 W MAIN ST",
            "city": "FREDERICKTOWN",
            "state": "MO",
            "postal_code": "636451113",
            "telephone_number": "573-783-4100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FREDERICKTOWN FAMILY DENTAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-09-15",
        "last_updated": "2015-09-16",
        "status": "A",
        "authorized_official_last_name": "ADAMS",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "573-783-4100"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Farmington Clinic Company LLC
• Linda Bernard Femmer, COTA
• Melinda Jo Fischer, RN, BC, FNP
• Christine Marie Forrest, CPS
• Christa M Forsythe, CCC SLP
• Fredericktown Medicate Pharmacy
• Fredericktown R-I School Dist
• Fredericktown Vision Center Inc
• Fred Wayne Gaskin, MD
• Claire Gibbs, PT

• General Practice Dentistry in Fredericktown, MO
• Providers in Fredericktown, MO by specialty
• General Practice Dentistry in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.