Individual provider Active NPI

Eric S Fried, DDS

  • Oral and Maxillofacial Surgery (Dentist)
  • Mayfield HTS, OH
National Provider Identifier
1295750453
Registry record updated May 29, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
30019419 Issued in OH
Practice address
5825 Landerbrook Drive
#125
Mayfield HTS, OH 44124
Phone
(440) 461-6390
Fax
(440) 461-2990
NPI assigned
Jul 12, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 29, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist) 1223S0112X 30019419 OH Primary

Addresses

Primary practice location

5825 Landerbrook Drive
#125
Mayfield HTS, OH 44124

Mailing address

5825 Landerbrook Drive
#125
Mayfield HTS, OH 44124-2209
Phone (440) 461-6390

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120302000580 OH Practitioner - Oral SurgeryPractitioner - Maxillofacial Surgery 2961563093 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Oral SurgeryAlso: Maxillofacial Surgery
Education
Ohio State University College of Dentistry, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Fried and Popper IncGroup PAC ID 3375577729, 2 clinicians

Practice addresses (Care Compare)

5825 Landerbrook Dr
Suite 125
Mayfield HTS, OH 44124-6533
Phone (440) 461-6390

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
30019419OHMDOral and Maxillofacial Surgery (Dentist)

Practice roles

OrganizationSpecialtyStatusNew patients
Fried & Popper Inc Oral and Maxillofacial Surgery CurrentSince Jul 18, 1995 Accepting new patients

Locations

5825 Landerbrook Dr
Ste 125
Mayfield Hts, OH 44124
Phone (440) 461-6390

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1152662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1212019200000",
    "number": "1295750453",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5825 LANDERBROOK DRIVE",
            "address_2": "#125",
            "city": "MAYFIELD HTS",
            "state": "OH",
            "postal_code": "441242209",
            "telephone_number": "440-461-6390",
            "fax_number": "440-461-2990"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5825 LANDERBROOK DRIVE",
            "address_2": "#125",
            "city": "MAYFIELD HTS",
            "state": "OH",
            "postal_code": "44124",
            "telephone_number": "440-461-6390",
            "fax_number": "440-461-2990"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRIED",
        "first_name": "ERIC",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-12",
        "last_updated": "2008-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "OH",
            "license": "30019419",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mayfield HTS, OH

Sources for this page

Verify at the official NPI Registry.