James Milton Fraser, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D11569 Issued in MI

Practice address

1976 Holland Ave
Port Huron, MI 48060-1520

Phone

(810) 987-7970

Fax

(810) 987-2726

NPI assigned

Dec 6, 2006

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

Enrolled in MI

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

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1165363200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1285793307",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1976 HOLLAND AVE",
            "city": "PORT HURON",
            "state": "MI",
            "postal_code": "480601520",
            "telephone_number": "810-987-7970",
            "fax_number": "810-987-2726"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1976 HOLLAND AVE",
            "city": "PORT HURON",
            "state": "MI",
            "postal_code": "480601520",
            "telephone_number": "810-987-7970",
            "fax_number": "810-987-2726"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRASER",
        "first_name": "JAMES",
        "middle_name": "MILTON",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-06",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "D11569",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Charles Forest
• Kelly Quinn Forstner
• Edward Forton
• Amy Fournier, OTRL
• Mary Margaret Francisco
• Fredric B Roberts Edd PC
• Leopold M Fregoli, MD
• Shelby Lynn Fretenborough
• Carrie Frey
• Regina M Friedmann, MSW, LMSW

• General Practice Dentistry in Port Huron, MI
• Providers in Port Huron, MI by specialty
• General Practice Dentistry in Michigan

• 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.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.