Individual provider Active NPI

Frederick William Parker, D.D.S., P. A.

  • Dentist
  • Fallston, MD
National Provider Identifier
1083772339
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
8055 Issued in MD
Practice address
2106 Fallston Rd
Fallston, MD 21047-1442
Phone
(410) 893-0513
Fax
(410) 893-7770
NPI assigned
Dec 5, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 8055 MD Primary

Addresses

Primary practice location

2106 Fallston Rd
Fallston, MD 21047-1442

Mailing address

2106 Fallston Rd
Fallston, MD 21047-1442
Phone (410) 893-0513

Other identifiers 1

IdentifierTypeStateIssuer
8055OtherMDDENTIST LICENSE

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
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
8055MDMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Fallston Dental Care Past Accepting new patients
Matthew E Winter DDS PA Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1165276800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1083772339",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2106 FALLSTON RD",
            "city": "FALLSTON",
            "state": "MD",
            "postal_code": "210471442",
            "telephone_number": "410-893-0513",
            "fax_number": "410-893-7770"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2106 FALLSTON RD",
            "city": "FALLSTON",
            "state": "MD",
            "postal_code": "210471442",
            "telephone_number": "410-893-0513",
            "fax_number": "410-893-7770"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARKER",
        "first_name": "FREDERICK",
        "middle_name": "WILLIAM",
        "name_prefix": "Mr.",
        "credential": "D.D.S., P. A.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-05",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MD",
            "license": "8055",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DENTIST LICENSE",
            "identifier": "8055",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fallston, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.