Fremont Health Center Dental Group

Primary specialty

DentistTaxonomy code 122300000X

License

D37743 Issued in CA

Legal business name

FREMONT HEALTH CENTER DENTAL GROUP

Practice address

2043 E Fremont St Ste 1
Stockton, CA 95205-5000

Phone

(209) 463-2345

Fax

(209) 463-1432

NPI assigned

Jul 20, 2007

Organization subpart

Yes

Parent organization

FREMONT HEALTH CENTER DENTAL GROUPAs reported in NPPES

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

Authorized official

Name

Miss Kelly Pippenger

Title

O.M

Phone

(209) 463-2345

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Raymond J Rishwain, DDS

  • General Practice Dentistry
  • Stockton, CA
  • NPI 1497877955
  NPD (past)
• Ravi Dev Thind, DDS

  • General Practice Dentistry
  • Stockton, CA
  • NPI 1467574905
  NPD (past)

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

{
    "created_epoch": "1184889600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1216166400000",
    "number": "1164622882",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2043 E FREMONT ST STE 1",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952055000",
            "telephone_number": "209-463-2345",
            "fax_number": "209-463-1432"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2043 E FREMONT ST STE 1",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952055000",
            "telephone_number": "209-463-2345",
            "fax_number": "209-463-1432"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FREMONT HEALTH CENTER DENTAL GROUP",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "FREMONT HEALTH CENTER DENTAL GROUP",
        "enumeration_date": "2007-07-20",
        "last_updated": "2008-07-16",
        "status": "A",
        "authorized_official_last_name": "PIPPENGER",
        "authorized_official_first_name": "KELLY",
        "authorized_official_title_or_position": "O.M",
        "authorized_official_telephone_number": "209-463-2345",
        "authorized_official_name_prefix": "Miss"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "CA",
            "license": "D37743",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DENTICAL",
            "identifier": "G89962-01",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Briawna L Freeman
• Michelle Fregoso
• Samantha Marie Fregoso
• William Freitas
• Fremont Center Pharmacy
• Kessange Gabriel French, DO
• James Morley Friedman, MD
• Lawrence Jay Friedman, M.A.
• Friends Outside
• Michaela Elaine Fris

• Dentist in Stockton, CA
• Providers in Stockton, CA by specialty
• Dentist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2008; 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.