NPIMap

Organization Active NPI

Melinda Fried DDS PC

Doing business as Homewood Dental Studio

  • Dental Clinic/Center
  • Homewood, IL
National Provider Identifier
1053951954
Registry record updated Jan 9, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
Legal business name
MELINDA FRIED DDS PC
Doing business as
Homewood Dental Studio
Practice address
1924 Hickory Rd
Homewood, IL 60430-2239
Phone
(708) 798-0444
NPI assigned
Jan 9, 2020
Last updated
Jan 9, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2020

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

Authorized official

Name
Melinda Fried, DDSNPI 1487017083
Title
Owner
Phone
(708) 539-1520

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X NU Primary

Addresses

Primary practice location

1924 Hickory Rd
Homewood, IL 60430-2239

Mailing address

1924 Hickory Rd
Homewood, IL 60430-2239

Other names 1

  • Homewood Dental Studio Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL dentrix

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1578528000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1578528000000",
    "number": "1053951954",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1924 HICKORY RD",
            "city": "HOMEWOOD",
            "state": "IL",
            "postal_code": "604302239"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1924 HICKORY RD",
            "city": "HOMEWOOD",
            "state": "IL",
            "postal_code": "604302239",
            "telephone_number": "708-798-0444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MELINDA FRIED DDS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-01-09",
        "last_updated": "2020-01-09",
        "certification_date": "2020-01-09",
        "status": "A",
        "authorized_official_last_name": "FRIED",
        "authorized_official_first_name": "MELINDA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "708-539-1520",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "dentrix",
            "affiliation": "N",
            "endpointDescription": "dental software",
            "address_1": "1924 Hickory Rd",
            "city": "Homewood",
            "state": "IL",
            "country_code": "US",
            "postal_code": "604302239",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Homewood Dental Studio",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Homewood, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2020; 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.