Paul Ellsworth Fracolli, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

29047 Issued in CA

Practice address

39572 Stevenson PL
231
Fremont, CA 94539-3075

Phone

(510) 795-2260

Fax

(510) 795-2264

NPI assigned

Feb 4, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1170547200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1235277872",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "39572 STEVENSON PL",
            "address_2": "231",
            "city": "FREMONT",
            "state": "CA",
            "postal_code": "945393075",
            "telephone_number": "510-795-2260",
            "fax_number": "510-795-2264"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "39572 STEVENSON PL",
            "address_2": "231",
            "city": "FREMONT",
            "state": "CA",
            "postal_code": "945393075",
            "telephone_number": "510-795-2260",
            "fax_number": "510-795-2264"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRACOLLI",
        "first_name": "PAUL",
        "middle_name": "ELLSWORTH",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-04",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "29047",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Robert Foster
• Diana Nicole Fox
• Dorothy M Fox, OTR/L
• Viki Mae Fox, R.D.A.
• Wendy Kay Fox
• Marta Gea Franca, MFTI
• Jeanette Frances
• Carmen Franchini
• Darian Michael Francia-Manago, LMFT
• Paul Francisco

• General Practice Dentistry in Fremont, CA
• Providers in Fremont, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.