Kristina Nichole Fredrickson, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

2901019576 Issued in MI

Practice address

720 East Blvd
Kingsford, MI 49802-4539

Phone

(906) 774-5087

NPI assigned

Jun 11, 2007

Last updated

Jan 13, 2016By 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

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

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.

• Santini Family Dentistry, PLLC

  dba Kristina N. Fredrickson, D.D.S

  • General Practice Dentistry
  • Kingsford, MI
  • NPI 1326654385
  NPD (past)

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

{
    "created_epoch": "1181520000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1452643200000",
    "number": "1285837823",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "720 EAST BLVD",
            "city": "KINGSFORD",
            "state": "MI",
            "postal_code": "498024539",
            "telephone_number": "906-774-5087"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "720 EAST BLVD",
            "city": "KINGSFORD",
            "state": "MI",
            "postal_code": "498024539",
            "telephone_number": "906-774-5087"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FREDRICKSON",
        "first_name": "KRISTINA",
        "middle_name": "NICHOLE",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-11",
        "last_updated": "2016-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "2901019576",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kristin Edwards, MA, CCC-SLP
• Hanna Paige Ellis
• Gail Esaman, PSS
• Amy Everett
• Family Chiropractic Clinic PC
• Alan K Fulks, D.D.S., M.S.
• Megan Garvaglia, LSST
• Karissa Ginzel, MS
• Chelsey Goad
• Dominique Golden

• General Practice Dentistry in Kingsford, MI
• Providers in Kingsford, 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 Jan 13, 2016; 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.