Individual provider Active NPI

Gregory Albert Fredette, D.M.D.

  • Dentist
  • Dover, NH
National Provider Identifier
1326309964
Registry record updated Dec 30, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
03976 Issued in NH
Practice address
801 Central Ave Ste 4
Dover, NH 03820-2529
Phone
(603) 744-8844
NPI assigned
May 30, 2012
Last updated
Dec 30, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 30, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 03976 NH Primary
General Practice Dentistry 1223G0001X DN185967 MA

Addresses

Primary practice location

801 Central Ave Ste 4
Dover, NH 03820-2529

Mailing address

801 Central Ave Ste 4
Dover, NH 03820-2529
Phone (603) 742-8844

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NH
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
I20131113001644 NH Practitioner - DentistPractitioner - General Practice 9739315177

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
03976NHMDDentist
DN185967MAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Garrison Dental Group, PLLC CurrentSince Jan 2, 2022 Accepting new patients

Locations

801 Central Ave
Ste 4
Dover, NH 03820
Phone (603) 742-8844

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1338336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640822400000",
    "number": "1326309964",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 CENTRAL AVE STE 4",
            "city": "DOVER",
            "state": "NH",
            "postal_code": "038202529",
            "telephone_number": "603-742-8844"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 CENTRAL AVE STE 4",
            "city": "DOVER",
            "state": "NH",
            "postal_code": "038202529",
            "telephone_number": "603-744-8844"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FREDETTE",
        "first_name": "GREGORY",
        "middle_name": "ALBERT",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-05-30",
        "last_updated": "2021-12-30",
        "certification_date": "2021-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NH",
            "license": "03976",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MA",
            "license": "DN185967",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dover, NH

Sources for this page

Verify at the official NPI Registry.