Maria S Fraser, D.M.D.

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

DN14127 Issued in FL

Practice address

1100 S Ponce de Leon Blvd
St Augustine, FL 32084-6099

Phone

(904) 829-6321

Fax

(904) 829-2338

NPI assigned

Oct 12, 2006

Last updated

Feb 27, 2013By the provider in NPPES

Sex

Female

Sole proprietor

No

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

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.

Opted out of Medicare

Yes, effective Jan 11, 2017 through Jan 11, 2027

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• McLellan Dental Inc.

  • Dentist
  • St Augustine, FL
  • NPI 1790920544
  NPD (past)
• Myers Pediatric Dentistry PA

  • Pediatric Dentistry
  • Middleburg, FL
  • NPI 1982619425
  NPD (past)
• Smiling Kidds Dentistry, P.a.

  dba Seaside Children's Dentistry

  • Pediatric Dentistry
  • St Augustine, FL
  • NPI 1881290211
  NPD (past)

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

{
    "created_epoch": "1160611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1361923200000",
    "number": "1245329093",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 S PONCE DE LEON BLVD",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320846099",
            "telephone_number": "904-829-6321",
            "fax_number": "904-829-2338"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 S PONCE DE LEON BLVD",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320846099",
            "telephone_number": "904-829-6321",
            "fax_number": "904-829-2338"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRASER",
        "first_name": "MARIA",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-12",
        "last_updated": "2013-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "FL",
            "license": "DN14127",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alexia Franco
• Anna Francois
• Frank W. Bowden, III, MD, Facs, PA (Bowden Eye & Associates)
• Alyssa Frankhouser, PT
• Louis R. Franzini, PH.D.
• Megan Ashley Fraser, B.A.
• Terra Ann Fraser
• Shelly Frechette, PT
• Melissa A Fredrickson, PA-C
• Danielle Free, LMHC

• Pediatric Dentistry in St Augustine, FL
• Providers in St Augustine, FL by specialty
• Pediatric Dentistry in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.