Active NPI
Kathryn Frey
- Dentist
- Roselle Park, NJ
National Provider Identifier
1235829938
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 22DI02985700
- Practice address
- 236 E Westfield Ave
Roselle Park, NJ 07204-2084 - Phone
- (908) 279-0621
- NPI assigned
- May 8, 2023
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 22DI02985700 | NJ | Primary |
Addresses
Primary practice location
236 E Westfield Ave
Roselle Park, NJ 07204-2084
Mailing address
770 S Bradford St
North Andover, MA 01845-1349
Phone (978) 994-9132
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
| License | State | Type | Specialty |
|---|---|---|---|
| 22DI02985700 | NJ | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1683504000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1692230400000",
"number": "1235829938",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "770 S BRADFORD ST",
"city": "NORTH ANDOVER",
"state": "MA",
"postal_code": "018451349",
"telephone_number": "978-994-9132"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "236 E WESTFIELD AVE",
"city": "ROSELLE PARK",
"state": "NJ",
"postal_code": "072042084",
"telephone_number": "908-279-0621"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FREY",
"first_name": "KATHRYN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-05-08",
"last_updated": "2023-08-17",
"certification_date": "2023-08-17",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "NJ",
"license": "22DI02985700",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Roselle Park, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.