Individual provider Active NPI

Dawn E Frein, DDS

  • Dentist
  • Sioux City, IA
National Provider Identifier
1063611002
Registry record updated Dec 19, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
08476 Issued in IA
Practice address
2928 Hamilton Blvd
Suite 102
Sioux City, IA 51104
Phone
(712) 255-5754
Fax
(712) 224-2075
NPI assigned
Jul 11, 2007
Last updated
Dec 19, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 19, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 08476 IA Primary

Addresses

Primary practice location

2928 Hamilton Blvd
Suite 102
Sioux City, IA 51104

Mailing address

2928 Hamilton Blvd
Suite 102
Sioux City, IA 51104
Phone (712) 255-5754

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150120002279 IA Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 4385968486

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
08476IAMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1184112000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1482105600000",
    "number": "1063611002",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2928 HAMILTON BLVD",
            "address_2": "SUITE 102",
            "city": "SIOUX CITY",
            "state": "IA",
            "postal_code": "51104",
            "telephone_number": "712-255-5754",
            "fax_number": "712-224-2075"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2928 HAMILTON BLVD",
            "address_2": "SUITE 102",
            "city": "SIOUX CITY",
            "state": "IA",
            "postal_code": "51104",
            "telephone_number": "712-255-5754",
            "fax_number": "712-224-2075"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FREIN",
        "first_name": "DAWN",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-11",
        "last_updated": "2016-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IA",
            "license": "08476",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sioux City, IA

Sources for this page

Verify at the official NPI Registry.