Individual provider Active NPI

Bruce Marc Fried, DDS

  • General Practice Dentistry
  • York, PA
National Provider Identifier
1205924735
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DS-025288L Issued in PA
Practice address
650 S Richland Ave
York, PA 17403-3446
Phone
(717) 846-5284
Fax
(717) 843-3951
NPI assigned
Oct 10, 2006
Sex
Male
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 DS-025288L PA Primary

Addresses

Primary practice location

650 S Richland Ave
York, PA 17403-3446

Mailing address

650 S Richland Ave
York, PA 17403-3446
Phone (717) 846-5284

Other identifiers 1

IdentifierTypeStateIssuer
DS-025288LOtherPADENTAL LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20160608001009 PA Order and Referring Only - Other (Physician)Practitioner - Other (Physician) 8123318862

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DS-025288LPAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Fried & Wright Past 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1160438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1205924735",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "650 S RICHLAND AVE",
            "city": "YORK",
            "state": "PA",
            "postal_code": "174033446",
            "telephone_number": "717-846-5284",
            "fax_number": "717-843-3951"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "650 S RICHLAND AVE",
            "city": "YORK",
            "state": "PA",
            "postal_code": "174033446",
            "telephone_number": "717-846-5284",
            "fax_number": "717-843-3951"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRIED",
        "first_name": "BRUCE",
        "middle_name": "MARC",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-10",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "PA",
            "license": "DS-025288L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DENTAL LICENSE",
            "identifier": "DS-025288L",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in York, PA

Sources for this page

Verify at the official NPI Registry.