Mark H Friedrich, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

12009422 Issued in IN

Practice address

7215 Engle Rd
Fort Wayne, IN 46804-2228

Phone

(260) 434-1133

Fax

(260) 459-3399

NPI assigned

Sep 11, 2007

Sex

Male

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 IN

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 and National Provider Directory roles.

• Legacy Dental LLC

  • General Practice Dentistry
  • Fort Wayne, IN
  • NPI 1083704019
  NPD (past)
• Robert J Ueber DDS PC

  • Customized Equipment (DME)
  • Fort Wayne, IN
  • NPI 1396150207
  NPD (past)

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

{
    "created_epoch": "1189468800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1189468800000",
    "number": "1346435591",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7215 ENGLE RD",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468042228",
            "telephone_number": "260-434-1133",
            "fax_number": "260-459-3399"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7215 ENGLE RD",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468042228",
            "telephone_number": "260-434-1133",
            "fax_number": "260-459-3399"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRIEDRICH",
        "first_name": "MARK",
        "middle_name": "H",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-09-11",
        "last_updated": "2007-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IN",
            "license": "12009422",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alicia Renee Frick
• Claire Frick
• Elizabeth Mercedes Frick
• Jan-Michael Jame Fridley, DPT
• Lora Friedrich, MSW, PHD
• Lauren Friel, BCBA
• Kathleen M Friend, PT
• Megan D Friend
• Rhonda Karen Friend
• Mallory L Fries

• Dentist in Fort Wayne, IN
• Providers in Fort Wayne, IN by specialty
• Dentist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2007; 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.