Individual provider Active NPI

Douglas B Fritz, DDS

  • Dentist
  • Tucson, AZ
National Provider Identifier
1063428969
Registry record updated Apr 11, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
5939 Issued in AZ
Practice address
4850 E. Broadway Blvd.
Frontier Dental
Tucson, AZ 85710
Phone
(520) 514-1883
Fax
(520) 514-1997
NPI assigned
Jul 31, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 11, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 5939 AZ Primary

Addresses

Primary practice location

4850 E. Broadway Blvd.
Frontier Dental
Tucson, AZ 85710

Mailing address

4850 E. Broadway Blvd.
Frontier Dental
Tucson, AZ 85710
Phone (520) 514-1883

Other identifiers 1

IdentifierTypeStateIssuer
835853MedicaidAZ

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

Practice roles

OrganizationSpecialtyStatusNew patients
Kino Dental Group 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.

NPI Registry JSON

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

{
    "created_epoch": "1154304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1302480000000",
    "number": "1063428969",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4850 E. BROADWAY BLVD.",
            "address_2": "FRONTIER DENTAL",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "85710",
            "telephone_number": "520-514-1883",
            "fax_number": "520-514-1997"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4850 E. BROADWAY BLVD.",
            "address_2": "FRONTIER DENTAL",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "85710",
            "telephone_number": "520-514-1883",
            "fax_number": "520-514-1997"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRITZ",
        "first_name": "DOUGLAS",
        "middle_name": "B",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-31",
        "last_updated": "2011-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "AZ",
            "license": "5939",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "835853",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tucson, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2011; 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.