Individual provider Active NPI

Darlyne Frazee, D.D.S.

  • General Practice Dentistry
  • Willoughby, OH
National Provider Identifier
1124175054
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
20027 Issued in OH
Practice address
36001 Euclid Ave
#A-3
Willoughby, OH 44094-4643
Phone
(440) 946-6373
NPI assigned
Jan 4, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 20027 OH Primary

Addresses

Primary practice location

36001 Euclid Ave
#A-3
Willoughby, OH 44094-4643

Mailing address

38430 Crossbrook Ave
Willoughby, OH 44094-8172
Phone (440) 942-6816

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20160516001732 OH Order and Referring Only - DentistPractitioner - Dentist 8325337280

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
20027OHMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1167868800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1124175054",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "38430 CROSSBROOK AVE",
            "city": "WILLOUGHBY",
            "state": "OH",
            "postal_code": "440948172",
            "telephone_number": "440-942-6816"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "36001 EUCLID AVE",
            "address_2": "#A-3",
            "city": "WILLOUGHBY",
            "state": "OH",
            "postal_code": "440944643",
            "telephone_number": "440-946-6373"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRAZEE",
        "first_name": "DARLYNE",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-04",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OH",
            "license": "20027",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Willoughby, OH

Sources for this page

Verify at the official NPI Registry.