Active NPI
Frederick Alan Roberts, D.D.S.
- Dentist
- Fairview Park, OH
National Provider Identifier
1376567446
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 18601
- Practice address
- 20800 Westgate Mall
#404
Fairview Park, OH 44126-1323 - Phone
- (440) 333-4063
- Fax
- (440) 333-5688
- NPI assigned
- Jul 26, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 18601 | OH | Primary |
Addresses
Primary practice location
20800 Westgate Mall
#404
Fairview Park, OH 44126-1323
Mailing address
20800 Westgate Mall
#404
Fairview Park, OH 44126-1323
Phone (440) 333-4063
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
| License | State | Type | Specialty |
|---|---|---|---|
| 18601 | OH | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153872000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1314835200000",
"number": "1376567446",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "20800 WESTGATE MALL",
"address_2": "#404",
"city": "FAIRVIEW PARK",
"state": "OH",
"postal_code": "441261323",
"telephone_number": "440-333-4063",
"fax_number": "440-333-5688"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "20800 WESTGATE MALL",
"address_2": "#404",
"city": "FAIRVIEW PARK",
"state": "OH",
"postal_code": "441261323",
"telephone_number": "440-333-4063",
"fax_number": "440-333-5688"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROBERTS",
"first_name": "FREDERICK",
"middle_name": "ALAN",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-07-26",
"last_updated": "2011-09-01",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "OH",
"license": "18601",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fairview Park, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.