Individual provider Active NPI

Kesha Stephenson-Frazier

  • Pediatric Dentistry
  • Alexandria, VA
National Provider Identifier
1205036464
Registry record updated May 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
14059 Issued in MD
Practice address
224 N Fayette St
Alexandria, VA 22314-2433
Phone
(703) 519-7275
NPI assigned
Jul 24, 2007
Last updated
May 28, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 28, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DEN1000627 DC
Pediatric Dentistry 1223P0221X 14059 MD Primary

Addresses

Primary practice location

224 N Fayette St
Alexandria, VA 22314-2433

Mailing address

224 N Fayette St
Alexandria, VA 22314-2433
Phone (703) 519-7275

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

State licenses

LicenseStateTypeSpecialty
DEN1000627DCMDGeneral Practice Dentistry
14059MDMDPediatric Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
Parker-Gray Pediatric Dental Care, PC Pediatric Dentistry PastSince Jun 3, 2025 Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1185235200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748390400000",
    "number": "1205036464",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "224 N FAYETTE ST",
            "city": "ALEXANDRIA",
            "state": "VA",
            "postal_code": "223142433",
            "telephone_number": "703-519-7275"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "224 N FAYETTE ST",
            "city": "ALEXANDRIA",
            "state": "VA",
            "postal_code": "223142433",
            "telephone_number": "703-519-7275"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEPHENSON-FRAZIER",
        "first_name": "KESHA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-24",
        "last_updated": "2025-05-28",
        "certification_date": "2025-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "DC",
            "license": "DEN1000627",
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "MD",
            "license": "14059",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Alexandria, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2025; 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.