Dr Frederic Clyde Rather DMD PC

Primary specialty

DentistTaxonomy code 122300000X

License

12008608A Issued in IN

Legal business name

DR FREDERIC CLYDE RATHER DMD PC

Practice address

9042 Columbia Ave
Suite a
Munster, IN 46321-2905

Phone

(219) 836-5656

Fax

(219) 836-0455

NPI assigned

Oct 19, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Frederic Clyde RatherNPI 1447260732

Title

Dentist

Phone

(219) 836-5656

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Frederic Clyde Rather, DMD

  • Dentist
  • Munster, IN
  • NPI 1447260732
  NPD (past) Authorized official

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

{
    "created_epoch": "1161216000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1316029374",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9042 COLUMBIA AVE",
            "address_2": "SUITE A",
            "city": "MUNSTER",
            "state": "IN",
            "postal_code": "463212905",
            "telephone_number": "219-836-5656",
            "fax_number": "219-836-0455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9042 COLUMBIA AVE",
            "address_2": "SUITE A",
            "city": "MUNSTER",
            "state": "IN",
            "postal_code": "463212905",
            "telephone_number": "219-836-5656",
            "fax_number": "219-836-0455"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR FREDERIC CLYDE RATHER DMD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-19",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "RATHER",
        "authorized_official_first_name": "FREDERIC",
        "authorized_official_middle_name": "CLYDE",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "219-836-5656",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "IN",
            "license": "12008608A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVISUAL NPI",
            "identifier": "1447260732",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Dentist in Munster, IN
• Providers in Munster, IN by specialty
• Dentist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.