Individual provider Active NPI

Andrew Fraser, DMD

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • South Weymouth, MA
National Provider Identifier
1366090896
Registry record updated Aug 28, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
License
DN1858445 Issued in MA
Practice address
1121 Main St Ste 1
South Weymouth, MA 02190-1567
Phone
(781) 337-1355
NPI assigned
Aug 28, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X DN1858445 MA Primary

Addresses

Primary practice location

1121 Main St Ste 1
South Weymouth, MA 02190-1567

Mailing address

1 India St Apt 3a
Boston, MA 02109-3300
Phone (978) 877-0817

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
DN1858445MAMDOrthodontics and Dentofacial Orthopedic Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
Myorthos Massachusetts Orthodontics. P.C. Orthodontics and Dentofacial Orthopedics PastSince Sep 1, 2019 Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1566950400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1566950400000",
    "number": "1366090896",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 INDIA ST APT 3A",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021093300",
            "telephone_number": "978-877-0817"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1121 MAIN ST STE 1",
            "city": "SOUTH WEYMOUTH",
            "state": "MA",
            "postal_code": "021901567",
            "telephone_number": "781-337-1355"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRASER",
        "first_name": "ANDREW",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-08-28",
        "last_updated": "2019-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "MA",
            "license": "DN1858445",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Weymouth, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2019; 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.