Individual provider Active NPI

Danielle Fridline, DDS

  • General Practice Dentistry
  • Brooklyn, NY
National Provider Identifier
1295964203
Registry record updated Jan 7, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
054938 Issued in NY
Practice address
220 13TH St
Brooklyn, NY 11215-4802
Phone
(718) 832-9677
Fax
(718) 492-5090
NPI assigned
Jul 11, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 7, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 054938 NY Primary

Addresses

Primary practice location

220 13TH St
Brooklyn, NY 11215-4802

Mailing address

220 13TH St
Brooklyn, NY 11215-4802
Phone (718) 832-9677

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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

Enrollment IDStateProvider typePAC IDDetails
I20160420000512 NY Order and Referring Only - DentistPractitioner - Dentist 9830497106

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
054938NYMDGeneral Practice Dentistry

Interoperability endpoints

  • Direct secure messaging: dfridline133747@nyumc.direct-ci.com

NPI Registry JSON

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

{
    "created_epoch": "1247270400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1357516800000",
    "number": "1295964203",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "220 13TH ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112154802",
            "telephone_number": "718-832-9677",
            "fax_number": "718-492-5090"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "220 13TH ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112154802",
            "telephone_number": "718-832-9677",
            "fax_number": "718-492-5090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRIDLINE",
        "first_name": "DANIELLE",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-07-11",
        "last_updated": "2013-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "054938",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.