Active NPI
Bret R Frye, D.D.S.
- Dentist
- Marietta, OH
National Provider Identifier
1083632483
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 30.019744
- Practice address
- 1309 Greene St
Marietta, OH 45750-9172 - Phone
- (740) 374-0123
- Fax
- (740) 374-0123
- NPI assigned
- Jul 17, 2006
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Dentist | 122300000X | 30.019744 | OH | Primary |
Addresses
Primary practice location
1309 Greene St
Marietta, OH 45750-9172
Mailing address
1309 Greene St
Marietta, OH 45750-9172
Phone (740) 374-0123
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Feb 23, 2022 through Feb 23, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 30.019744 | OH | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153094400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1539043200000",
"number": "1083632483",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1309 GREENE ST",
"city": "MARIETTA",
"state": "OH",
"postal_code": "457509172",
"telephone_number": "740-374-0123",
"fax_number": "740-376-9985"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1309 GREENE ST",
"city": "MARIETTA",
"state": "OH",
"postal_code": "457509172",
"telephone_number": "740-374-0123",
"fax_number": "740-374-0123"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FRYE",
"first_name": "BRET",
"middle_name": "R",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-17",
"last_updated": "2018-10-09",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "OH",
"license": "30.019744",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Marietta, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.