Individual provider Active NPI

Genneve Frerking, RDH

  • Dental Hygienist
  • Los Angeles, CA
National Provider Identifier
1205350550
Registry record updated Jul 28, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental HygienistTaxonomy code 124Q00000X
License
26310 Issued in CA
Practice address
1625 E 4TH St
Los Angeles, CA 90033-4201
Phone
(213) 254-7244
NPI assigned
Jul 28, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Hygienist 124Q00000X 26310 CA Primary

Addresses

Primary practice location

1625 E 4TH St
Los Angeles, CA 90033-4201

Mailing address

7151 Tiara LN
La Palma, CA 90623-1157
Phone (928) 897-1982

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
26310CAMDPsychologist

NPI Registry JSON

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

{
    "created_epoch": "1501200000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1501200000000",
    "number": "1205350550",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7151 TIARA LN",
            "city": "LA PALMA",
            "state": "CA",
            "postal_code": "906231157",
            "telephone_number": "928-897-1982"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1625 E 4TH ST",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900334201",
            "telephone_number": "213-254-7244"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRERKING",
        "first_name": "GENNEVE",
        "credential": "RDH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-07-28",
        "last_updated": "2017-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "124Q00000X",
            "taxonomy_group": "",
            "desc": "Dental Hygienist",
            "state": "CA",
            "license": "26310",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2017; 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.