NPIMap

Katelyn Ann Frierott, DDS

Individual provider Active NPI General Practice Dentistry · Maplewood, MN

NPI 1124609003 · NPPES record last updated Jul 25, 2021

Key facts

NPI
1124609003
Entity type
Individual (NPI type 1)
Primary specialty
General Practice Dentistry 1223G0001X
License
D14541 (MN)
Practice address
1670 Beam Ave Ste 204
Maplewood, MN 55109-1227
Phone
(651) 925-8400
NPI assigned
Apr 21, 2021
Sex
Female
Sole proprietor
No

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 and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
D14541MNMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Community Dental Care Inc General Practice Current
since Mar 6, 2022		 Accepting new patients

Locations

1670 Beam Ave
Ste 204
Saint Paul, MN 55109
Phone (651) 925-8400

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
General Practice Dentistry 1223G0001X D14541 MN Yes

Addresses

Primary practice location

1670 Beam Ave Ste 204
Maplewood, MN 55109-1227

Mailing address

9700 Waterstone PL Apt 209
Hopkins, MN 55305-7503
Phone (901) 378-3555

Other providers in Maplewood, MN

All providers in Maplewood, MN · General Practice Dentistry in Minnesota

Sources for this page

Verify at the official NPI Registry.